Please select the eligibility criteria that correspond to the clinical trial below.
Title: Procalcitonin-Guided Antimicrobial Discontinuation Strategy in Critically Ill Patients With Suspected or Confirmed Bacterial Sepsis
Brief Summary: The current study aims to validate the diagnostic use of PCT assessing its capability to individualize and shorten the duration of antibiotic therapy in critically ill patients with suspected or confirmed sepsis.

In particular, no well-designed intervention study has properly examined the following hypothesis: A PCT-guided antibiotic discontinuation strategy enables to reduce antibiotic treatment duration in critically ill patients with suspected or documented sepsis, without harming patient safety.


Options:
A: Inclusion Criteria:

* Hospitalized with symptoms of a respiratory infection
* Age \> 21 years
* Systolic Blood Pressure \> 90mm Hg
* Patient or health care designee can provide written informed consent

Exclusion Criteria:

* Intensive Care Requirement
* Antibiotics received prior to admission
* More than 24 hours of antibiotics received prior to enrollment
* Active chemotherapy or pulmonary radiation therapy
* Immunosuppressive conditions
* Conditions know to increase PCT values
* Definite infiltrate on CXR •% of band forms in peripheral blood \> 15
B: Inclusion Criteria:

* age \> 17 years
* patients in intensive care unit
* signed informed consent
* suspected or confirmed severe sepsis or septic shock

Exclusion Criteria:

* Infections caused by Listeria spp, Legionella pneumophilia, Mycobacterium tuberculosis
* Bacteremia due S. aureus
* Infections requiring prolonged therapies, such as endocarditis, cerebral abscess, chronic osteomyelitis
* Suspected or confirmed infection caused by virus, parasites
* Infections caused by P. aeruginosa ou A. baumannii
* Severe immunosuppression (ex: AIDS, post bone-marrow transplant,cystic fibrosis)
* Traumatism latest five days
* Surgery latest 5 days
* Carcinoid tumor, lung cancer, medullary thyroid cancer
C: Inclusion Criteria:

1. Patients with clinically suspected or microbiologically confirmed bacterial sepsis
2. Informed consent

Exclusion Criteria:

1. Patients with microbiologically documented infections caused by the following microorganisms: Listeria spp, Legionella pneumophilia, Mycobacterium tuberculosis, Staphylococcus aureus
2. Patients with fungal infections
3. Patients with severe infections due to viruses or parasites (e.g. hemorrhagic fever, malaria)
4. Patients with suspected or confirmed bacterial meningitis or endocarditis
5. Patients with localized, deep-seated abscesses (e.g. brain abscess) without systemic sepsis
6. Patients with chronic, localized infections (e.g. chronic osteomyelitis) without systemic sepsis
7. Neutropenic and other severely immuno-compromised patients (patients infected with human immunodeficiency virus and a CD4 count \< 200; patients on immuno-suppressive therapy after solid organ transplantation; patients with cystic fibrosis)
8. Withholding of life-support
9. Early discharge or death (\< 24 hours after admission)
10. Complete absence of antimicrobial treatment despite suspicion of sepsis
D: Inclusion Criteria:

* 18 years or older
* Informed consent
* Respiratory tract infection based on the clinical judgement of the primary care physician

Exclusion Criteria:

* Antibiotic pretreatment in previous 14 days
* Portal hypertension
* Major surgeries or multiple trauma which require hospitalization, in previous 4 weeks
* Autoimmune disease and systemic diseases (lupus erythematodes, wegener´s disease)
* Peritoneal dialysis
* Acute treated or recently operated medullary c-cell-carcinoma, SCLC, carcinoid
* Other inflammatory diseases (e.g. urinary tract infection, pyelonephritis, pancreatitis

Answer: C