Understanding the gap between clinical presentation and appropriate prescribing is essential for primary care practitioners. Three key takeaways emerge from recent evidence on biomarker-guided antibiotic stewardship:
First, the scale of the problem cannot be overstated: 70–80% of respiratory tract infections in primary care are viral in origin, yet antibiotics remain routinely prescribed. This reflects a persistent clinical paradox in which diagnostic uncertainty drives unnecessary antimicrobial exposure. Second, biomarker testing demonstrates substantial clinical utility, with procalcitonin and C-reactive protein achieving 70–90% accuracy in differentiating bacterial from viral infections when interpreted within appropriate clinical contexts. These tools provide objective data that can support clinical judgment and reduce reliance on empiric prescribing.
Third, real-world implementation success requires more than diagnostic innovation—it demands health system investment in infrastructure, clinician training programs, and reimbursement models that incentivize evidence-based practice. Without addressing these structural barriers, even highly accurate biomarkers will struggle to achieve meaningful clinical adoption.
Read the full article on GMJ Newsroom.
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