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David N. Schwartz, MD

Arch Intern Med. 2008;168(18):2007-2008.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Clinicians treating respiratory tract infections in ambulatory settings must reconcile patients' frequent expectations for prescriptions for antibiotics (whether perceived or actual¹) with evidence that antibiotics confer little, if any, benefit for these common and mostly viral syndromes.^2-3 Lingering concerns about primary bacterial infection, whether self-limited (eg, Mycoplasma pneumoniae), life-threatening (eg, Neisseria meningiditis⁴), clinically occult, or an impending bacterial superinfection¹ (eg, bacterial sinusitis or pneumonia), also militate against withholding antibiotics. No wonder, then, that the decision to prescribe antibiotics provokes more discomfort among office-based general practitioners than the use of any other class of drugs.⁵

An accurate test for the presence or absence of bacterial infection would therefore be welcomed by many clinicians⁶ and, potentially, could lead to marked reductions in antibiotic prescriptions for respiratory tract infections. Although commonly used, C-reactive protein is insufficiently sensitive to rule out bacterial infection,⁷ as are the erythrocyte . . . [Full Text of this Article]

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