BACKGROUND: Acute @entity1729 (ARTI) are among the most frequent reasons for consultations in primary care. Although predominantly viral in origin, ARTI often lead to the prescription of antibiotics for ambulatory @entity1 , mainly because it is difficult to distinguish between viral and @entity2348 . Unnecessary antibiotic use, however, is associated with increased drug expenditure, side effects and antibiotic resistance. A novel approach is to guide antibiotic therapy by @entity1904 (ProCT), since serum levels of ProCT are elevated in @entity2348 but remain lower in @entity1800 and inflammatory diseases. The aim of this trial is to compare a ProCT-guided antibiotic therapy with a standard approach based on evidence-based guidelines for @entity1 with ARTI in primary care. METHODS/DESIGN: This is a randomised controlled trial in primary care with an open intervention. Adult @entity1 judged by their general practitioner (GP) to need antibiotics for ARTI are randomised in equal numbers either to standard antibiotic therapy or to ProCT-guided antibiotic therapy. @entity1 are followed-up after 1 week by their GP and after 2 and 4 weeks by phone interviews carried out by medical students blinded to the goal of the trial. Exclusion criteria for patients are antibiotic use in the previous 28 days, @entity146 or inability to give written informed consent, not being fluent in German, severe immunosuppression, intravenous drug use, cystic @entity82 , active @entity378 , or need for immediate hospitalisation. The primary endpoint is days with restrictions from ARTI within 14 days after randomisation. Secondary outcomes are antibiotic use in terms of antibiotic prescription rate and duration of antibiotic treatment in days, days off work and days with side-effects from medication within 14 days, and relapse rate from the infection within 28 days after randomisation. DISCUSSION: We aim to include 600 @entity1 from 50 general practices in the Northwest of Switzerland. Data from the registry of the Swiss Medical Association suggests that our recruited GPs are representative of all eligible GPs with respect to age, proportion of female physicians, specialisation, years of postgraduate training and years in private practice.

@entity1904 -guided antibiotic use versus a standard approach for acute XXXX in primary care: study protocol for a randomised controlled trial and baseline characteristics of participating general practitioners [ISRCTN73182671].

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity82 :: ('MESH:D005355', 'Disease') :: ['fibrosis'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric disorders'] @entity1904 :: ('MESH:C029100', 'Chemical') :: ['procalcitonin'] @entity2348 :: ('MESH:D001424', 'Disease') :: ['bacterial infections'] @entity1800 :: ('MESH:D014777', 'Disease') :: ['viral infections'] @entity1729 :: ('MESH:D012141', 'Disease') :: ['respiratory tract infections'] @entity378 :: ('MESH:D014376', 'Disease') :: ['tuberculosis']
@entity1729 :: (MESH:D012141,Disease) :: ['respiratory tract infections']
