Potential of serum procalcitonin in predicting bacterial exacerbation and guiding antibiotic administration in severe COPD exacerbations: a systematic review and meta-analysis

Clinical differences between eosinophilic and non-eosinophilic acute exacerbation of chronic obstructive pulmonary disease (AECOPD), a multicenter cross-sectional study

“…Simultaneously, several studies showed that airway eosinophilic in ammation was related to viral infection in AECOPD [35,41]. Additionally, it is con rmed that blood neutrophils and PCT are the biomarkers of bacterial infection in COPD [44]. In a meta-analysis, Ni W et al showed that the sensitivity and speci city of PCT in diagnosing bacterial infections were 0.60 and 0.76, and AUC of ROC curve was 0.77 [44].…”

“…Additionally, it is con rmed that blood neutrophils and PCT are the biomarkers of bacterial infection in COPD [44]. In a meta-analysis, Ni W et al showed that the sensitivity and speci city of PCT in diagnosing bacterial infections were 0.60 and 0.76, and AUC of ROC curve was 0.77 [44]. Ergan B et al found that compared with culture-negative patients, PCT was markedly increased in culture-positive patients in AECOPD [45].…”

Procalcitonin for Antibiotic Prescription in Chronic Obstructive Pulmonary Disease Exacerbations: Systematic Review, Meta-Analysis, and Clinical Perspective

“…A recent meta-analysis by Ni et al, which included many of the studies in our analysis, found that the use of PCT decreased antibiotic use in patients with COPD exacerbation, and suggested that it had moderate ability to distinguish bacterial infection. However, they pooled RCTs and observational studies, which is a less reliable approach [5,40].…”

“…In contrast, the 2020 GOLD report indicates PCT is a potentially useful biomarker for COPD exacerbation because it is more sensitive for bacterial infection than CRP. The GOLD report also notes low to moderate evidence based on two prior meta-analyses [4,5] for PCT in COPD exacerbation, conflicting findings among studies, and higher mortality when employed in the intensive care unit (ICU) setting [6]. The United Kingdom National Institute for Health and Care Excellence (NICE) guidelines do not provide any recommendations for CRP or PCT in COPD exacerbation [7].…”

Quality and safety in the literature: January 2020

“…For lower respiratory illnesses, these newer tests include rapid viral panels using PCR and the biomarker procalcitonin, the latter of which may be elevated in bacterial infections. The evidence is mixed for the benefit of procalcitonin to guide antimicrobial prescribing in acute exacerbations of COPD 12–15. C-reactive protein (CRP) is a biomarker that may be elevated in a variety of medical illnesses including infection.…”