ABSTRACT
The level of procalcitonin (PCT) in children is undetectable in healthy in¬dividuals and slightly increased in viral infections and noninfectious inflam¬matory responses. It has been described to be notably increased in bacteri¬al, parasitic, or fungal infections.
Acute respiratory tract infections (ARTI) of this study include, pharyngi¬tis, tonsillitis, rhino sinusitis, otitis media. As much as 75% of antibiotics are prescribed for ARTI, despite the mainly viral origin.
The objective of this trail is to evaluate, if a PCT-guided diagnostic strat¬egy leads to reduction of antibiotic use for patients with ARTI in primary care compared to standard approaches as C-reactive protein (CRP) and to¬tal leucocytic count (TLC).
This study included 110 children, 20 of them were apparently healthy as a control group. The diseased group; 30 children with pharyngotonsillitis, 30 children had acute rhino sinusitis and 30 children with acute otitis media.
PCT, CRP and TLC were evaluated for control and diseased groups. Culture for diseased group from blood, post nasal and ear discharge was done. Also, detection for adenovirus and respiratory syncetial virus antigen
No significant difference was observed between 2 groups as regards age and sex distribution. In the diseased group; 43 (47.8%) children had viral infection and 52.2% had bacterial ARTI.
Procalcitinin level was significantly higher in children with bacterial in¬fection (6.9 ±1 6.3ng/L) than those this viral ARTI (0.9 ± 2.8 ng/L) and non¬infected or control group (0.1 ±0.4). The mean value for CRP was 5.1 ± 1.8, 32 ± 13.8 and 12 ± 7.1 in control, bacterial and viral groups.
The mean value ofTLC was 10.1 ±5.8, 19.1 ±6.8 and 12.1 ± 7.3 for the groups respectively with no significant value.
It was concluded that the procalcition level had higher sensitivity, speci¬ficity for differention bacterial and viral infections than C reactive protein or leucocytic count. So PCT may be a guide for using antibiotic therapy by differentiating bacterial from viral ARTI.
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