How do you incorporate positive respiratory viral testing and/or low procalcitonin into antibiotic de-escalation when chest imaging still suggests pneumonia in a hospitalized patient?

De-escalation of antibiotic use is a key part of antimicrobial stewardship. Respiratory illnesses are one of the most common reasons for hospitalization, and bacterial pneumonia is frequently the major concern in these patients. However, there is evidence that we overdiagnose and treat bacterial pne...

Pneumonia is not a radiographic diagnosis, and an infiltrate does not tell us the pathogen. Chest radiographic abnormalities overlap substantially between viral and bacterial pneumonia; in the EPIC pediatric cohort, for example, consolidation was present in 74% of typical bacterial infections but al...