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BACKGROUND	Patients with severe acute exacerbations of asthma often receive inappropriate antibiotic treatment .
BACKGROUND	We aimed to determine whether serum procalcitonin ( PCT ) levels can effectively and safely reduce antibiotic exposure in patients experiencing exacerbations of asthma .
METHODS	In this randomized controlled trial , a total of 216 patients requiring hospitalization for severe acute exacerbations of asthma were screened for eligibility to participate and 169 completed the 12-month follow-up visit .
METHODS	Patients were randomized to either PCT-guided ( PCT group ) or standard ( control group ) antimicrobial therapy .
METHODS	In the control group , patients received antibiotics according to the attending physician 's discretion ; in the PCT group , patients received antibiotics according to an algorithm based on serum PCT levels .
METHODS	The primary end point was antibiotic exposure ; secondary end points were clinical recovery , length of hospital stay , clinical and laboratory parameters , spirometry , number of asthma exacerbations , emergency room visits , hospitalizations and need for corticosteroid use due to asthma .
RESULTS	PCT guidance reduced antibiotic prescription ( 48.9 % versus 87.8 % , respectively ; P < 0.001 ) and antibiotic exposure ( relative risk , 0.56 ; 95 % confidence interval , 0.44 to 0.70 ; P < 0.001 ) compared to standard therapy .
RESULTS	There were no significant differences in clinical recovery , length of hospital stay or clinical , laboratory and spirometry outcomes in both groups .
RESULTS	Number of asthma exacerbations , emergency room visits , hospitalizations and need for corticosteroid use due to asthma were similar during the 12-month follow-up period .
CONCLUSIONS	A PCT-guided strategy allows antibiotic exposure to be reduced in patients with severe acute exacerbation of asthma without apparent harm .
BACKGROUND	Chinese Clinical Trial Register ChiCTR-TRC-12002534 ( registered 26 September 2012 ) .

