Background. Recent trials suggest procalcitonin-based guidelines can reduce antibiotic use
for respiratory infections. However, the accuracy of procalcitonin to discriminate between
viral and bacterial pneumonia requires further dissection. Methods. We evaluated the
association between serum procalcitonin concentration at hospital admission with
pathogens detected in a multicenter prospective surveillance study of adults hospitalized
with community-acquired pneumonia. Systematic pathogen testing included cultures …

To the Editor—We appreciate the comments from Abers and Musher [1] in response to our
recent article describing the association between procalcitonin and etiology in community-
acquired pneumonia [2]. We agree with them that withholding antibiotics from a patient with
bacterial pneumonia has the potential to harm the patient and should be avoided. Based on
the principle of never missing bacterial pneumonia, nearly all adults with pneumonia
diagnosed in the United States are empirically treated with antibiotics [3, 4]. However, many …