Procalcitonin vs C-Reactive Protein as Predictive Markers of Response to Antibiotic Therapy in Acute Exacerbations of COPD

Daniëls, Hans; Schoorl, Marianne; Snijders, Dominic; Knol, Dirk L.; Lutter, René; Jansen, Henk M.; Boersma, Wim

doi:10.1378/chest.09-2927

Cited by 113 publications

(82 citation statements)

References 22 publications

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“…Spontaneous resolution in placebo-treated and/or new exacerbations in patients initially given antibiotics will decrease the separation in clinical responses if assessed later. In contrast to previous literature, PCT did not predict patients more likely to respond to antibiotic therapy (41). A substantial number of patients with low PCT levels benefited from doxycycline.…”

Section: Acute Exacerbations Of Chronic Obstructive Pulmonary Diseasecontrasting

confidence: 99%

Update in Pulmonary Infections 2010

Wunderink¹,

Waterer²

2011

Am J Respir Crit Care Med

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Section: Acute Exacerbations Of Chronic Obstructive Pulmonary Diseasecontrasting

confidence: 99%

Update in Pulmonary Infections 2010

Wunderink¹,

Waterer²

2011

Am J Respir Crit Care Med

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“…to identify patients with COPD exacerbations requiring antibiotic therapy. (8,9,10) This may soon get integrated into the guidelines for using antibiotics in COPD exacerbations.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Antibiotics in Acute Exacerbations of Copd

Nair¹,

Nair²,

Rasheed³

2017

jemds

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BACKGROUNDCOPD is characterised by frequent exacerbations, mostly infective. These are usually treated with antibiotics, even when the aetiology is non-infective. The efficacy of antibiotics in this setting is controversial. Hence, the study was planned to look for any added advantage for antibiotics in COPD exacerbations. Aim-To study the usefulness of antibiotics in acute exacerbations of COPD in a) reducing relapse of exacerbation and b) reducing duration of hospital stay.

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“…A variety of studies have shown that PCT levels are effective for diagnosis, outcome prediction, and efficacy of therapy for various populations, including infants, adults, and elderly patients with different sites of infections (4,11,18,30). However, a recent report assessed the value of PCT and CRP and found that in COPD patients PCT levels are not associated with bacterial presence and that benefit from antibiotic therapy is more likely with low PCT levels (9). In addition, PCT may not be the best predictor of outcomes in CAP (20).…”

Section: Discussionmentioning

confidence: 99%

Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections

Luo

Blackwell

et al. 2011

Antimicrob Agents Chemother

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Circulating procalcitonin (PCT) is a biomarker that can be used in diagnosing bacterial infections. We performed a quantitative meta-analysis of available randomized controlled trials to determine whether antibiotic therapy based on PCT measurements alters clinical outcomes and antibiotic use in patients with lower respiratory tract infections. We identified studies through MEDLINE (1996 to 2010), the ISI Web of Knowledge (1996 to 2010), and Ovid. Studies that met our criteria were prospective, randomized controlled trials involving patients with respiratory tract infections. Outcomes of mortality, intensive care unit (ICU) admission, length of hospital stay, number of antibiotic prescriptions, and duration of antibiotic treatment were evaluated. Eight studies randomizing 3,431 patients met our criteria for inclusion. Pooled analysis showed a significant reduction in number of antibiotic prescriptions and duration of antibiotic use in patients with PCT-guided antibiotic treatment compared to standard therapy. In addition, the use of PCT-guided antibiotic therapy did not impact mortality, ICU admission, or length of hospital stay in these studies. A high degree of heterogeneity was identified in 3 of 5 outcomes that were evaluated, and sensitivity analysis indicated that heterogeneity was decreased among studies using the same PCT-based treatment algorithm. In conclusion, PCT-guided antibiotic therapy in patients with respiratory tract infections appears to reduce antibiotic use without affecting overall mortality or length of stay in the hospital.

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Procalcitonin vs C-Reactive Protein as Predictive Markers of Response to Antibiotic Therapy in Acute Exacerbations of COPD

Cited by 113 publications

References 22 publications

Update in Pulmonary Infections 2010

Update in Pulmonary Infections 2010

Usefulness of Antibiotics in Acute Exacerbations of Copd

Meta-Analysis and Systematic Review of Procalcitonin-Guided Therapy in Respiratory Tract Infections

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