TY - JOUR T1 - Was the implementation strategy of the ProACT trial adequately proactive? JF - Breathe JO - Breathe SP - 77 LP - 80 DO - 10.1183/20734735.0338-2018 VL - 15 IS - 1 AU - Alexander G. Mathioudakis AU - Jørgen Vestbo Y1 - 2019/03/01 UR - http://breathe.ersjournals.com/content/15/1/77.abstract N2 - Rising antimicrobial resistance rates represent an alarming threat to public health, currently causing over 25 000 and 23 000 deaths per year in European Union and the USA, respectively [1, 2]. The significant global overuse of antibiotics amplifies the development of resistant bacterial strains [1, 2]. A recent national audit in the USA estimated that almost half of all antibiotic prescriptions were issued for respiratory tract infections (221 antibiotic prescriptions per 1000 population per year) and half of them were inappropriate [3]. Extensive campaigns have been carried out to promote antibiotic stewardship guidance in an attempt to limit the administration of unneeded antibiotics, but their impact has been modest [4, 5].The ProACT trial does not inform the evidence base regarding safety and clinical effectiveness of procalcitonin (PCT) as a biomarker to guide antibiotic administration for LRTIs, but reveals potential challenges in the introduction of PCT in real life. http://ow.ly/Enfr30n2TK6 ER -