The diagnostic performance of procalcitonin and neopterin as markers for bacterial and viral causes of fever was evaluated in a cohort of 69 febrile travellers with known etiological agents. Our aim was to establish a decision rule to minimize empirical antibiotic treatment. Compared with C-reactive protein (CRP) and leukocyte (differential) counts, procalcitonin and neopterin had a disappointing diagnostic accuracy. Refraining from antibiotics in case of combined presence of lymphocytosis and/or CRP ≤10. mg/l would result in an 85% reduction in unwanted antibiotic treatment in patients with viral disease but in adequate antibiotic coverage of all patients with bacterial disease.

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Royal Society of Tropical Medicine and Hygiene. Transactions
Department of Medical Microbiology and Infectious Diseases

te Witt, R, Hassing, R.J, Petit, P.P, van Belkum, A.F, & van Genderen, P.J.J. (2012). Procalcitonin and neopterin levels do not accurately distinguish bacterial from viral infections in ill-returned travellers with fever. Royal Society of Tropical Medicine and Hygiene. Transactions, 106(4), 264–266. doi:10.1016/j.trstmh.2012.01.001