The advent of antibiotics led to dramatic reductions in mortality and medical complications from bacterial respiratory tract infections.1 Although the armamentarium of diagnostic and therapeutic approaches has increased exponentially since that time, the effect of these advances on patient outcomes is less dramatic. Nevertheless, the goal of care remains constant: to match the patient's illness with a treatment approach that optimizes recovery while causing no harm. Harm exists in at least 2 forms: patient-specific, from an adverse event due to a diagnostic test or a treatment,2 and population-based, from the development of bacterial resistance promoted by the misuse or overuse of antibiotics.1,3
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The Rational Clinical Examination: Evidence-Based Clinical Diagnosis
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