Comment.

This paper was selected because there is considerable interest in procalcitonin as a marker of bacterial infection in patients with diverse enigmatic conditions. Europeans are far ahead of the United States in terms of both research and clinical use of procalcitonin levels for antibiotic decisions. Multiple smaller previous trials have shown that the use of procalcitonin for antibiotic decisions is associated with a substantial decrease in antibiotic use. The topic is relevant to the United States because of current interest in the US Food and Drug Administration (FDA) for review and possible clearance of procalcitonin levels as a method to facilitate clinical care with respect to the use or nonuse of antibacterial agents. The present study showed comparable outcomes in terms of mortality and length of stay and an average reduction of 3.3 days of antibiotic exposure.