Annals Journal Club: Point-of-Care C-Reactive Protein to Assist Antibiotic Prescribing for Respiratory Tract Infections

In my opinion, this topic is intriguing, but the discussion is not updated, since unfortunately Quantum Biophysical Semeiotics is overlooked (www.semeioticabiofisica.it). In fact, first of all, in ascertaining every respiratory infections we have to differential diagnose the disease from its nature view-point: viral, Gram-positive, or Gram-negative bacteria. Really, nowadays it is very difficult to know the real nature of an infectious disorder, including those of respiratory tract, both at the bed -side and in ER or hospital, not to speak of disorders recognizable by means of the academic, orthodox, physical semeiotics, as allows me to state a 54-year-long clinical experience. As a matter of fact, I am filled with wonder at reading that there are doctors who are sharing the uncertainty of the value of antibiotics for acute tonsillitis, pharingitis, bronchitis in the form of written and verbal advice, although I do not know if these physicians are skill at performing the advancement in the field of physical examination (1). interestingly, I underscore here the possibility of bedside recognizing easily and quickly the “chronic” antibodies synthesis in the spleen, absent during flu, as well as the spleen “small” antibody production, in case of Gram-negative bacteria (Esch.coli, HP, a.s.o.), which play a pivotal role in bed-side diagnosis of virus or Gram-negative infections (1-3). Moreover, interestingly, doctors can now-a-day observe clinically, and in a “quantitative” way, the so-called Reticulo- Endothelial-System-Hyperfunction Syndrome (RESH), which parallels with ESR and Proteins Electrophoresis, but it is “more” sensitive and specific than both (2-3). Certainly, most adults, and children, of course, with acute bronchitis who consult their general practitioner (as well as University Professors...) will receive antibiotics, although in many cases antibiotics do not modify the natural course of the disorder, at all. In my mind, the real problem is to recognize “clinically” both the nature of infectious disorder and the actual patient's defence , including antibody and PCR synthesis (illustrated in above-cited website, in Practical Applications): firstly, the “etiological” , complete diagnose, starting from bedside recognizing all constitutions (4) and, then, the proper therapy. Nowadays, we can solve the problem of acute respiratory tract infections, and a lot of others, if we are determined to be open-minded physicians, Referees and peer-review's Editors. 1) Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Ed. Travel Factory SRL., Roma, 2004. www.travelfactory.it 2) Stagnaro-Neri M., Stagnaro S., Appendicite. Min. Med. 87, 183, 1996[MEDLINE] 3) Stagnaro S., Sindrome percusso-ascoltatoria di Iperfunzione del Sistema Reticolo-Istiocitario Min. Med. 74, 479, 1983 [MEDLINE]. 4) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. 5) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005.

Competing interests:   None declared