Use of procalcitonin to guide antibiotic treatment in patients with acute respiratory infections reduces antibiotic exposure and side-effects, and improves survival.

Widespread implementation of procalcitonin protocols in patients with acute respiratory infections thus has the potential to improve antibiotic management with positive effects on clinical outcomes and on the current threat of increasing antibiotic multiresistance.

We identified 990 records from the literature search, of which 71 articles were assessed for eligibility after exclusion of 919 records.

We collected data on 6,708 patients from 26 eligible trials in 12 countries.

Mortality at 30 days was significantly lower in procalcitonin-guided patients than in control patients.

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