Procalcitonin-guided antibiotic therapy for chronic obstructive pulmonary disease exacerbations

作者：Tokman Sofya^*; Schuetz Philipp; Bent Stephen

来源：Expert Review of Anti-Infective Therapy, 2011, 9(6): 727-735.

DOI：10.1586/ERI.11.45

• antibiotic guidance
• chronic obstructive pulmonary disease
• COPD exacerbation
• procalcitonin

The aim of this article is to review the current literature examining the use of procalcitonin-guided antibiotic therapy for management of chronic obstructive pulmonary disease (COPD) exacerbations. Procalcitonin is a serum marker that rises in response to bacterial infections, but remains low in nonbacterial infections and other proinflammatory conditions. To date, there are four randomized clinical trials which compare procalcitonin-guided antibiotic therapy to standard therapy in patients with COPD exacerbations. In all four trials the use of procalcitonin was associated with a reduction in antibiotic use (prescription and/or duration) without an increase in the rates of adverse patient outcomes including death, admission to the intensive care unit, re-exacerbation and readmission to the hospital. This data is clinically significant and suggests that the use of procalcitonin-guided antibiotic therapy has the potential to decrease unnecessary antibiotic use in nonbacterial COPD exacerbations, thereby curtailing the spread of antibiotic-resistant bacteria, reducing antibiotic-related adverse reactions, including Clostridium difficile infection, and potentially reducing healthcare costs.

• 出版日期2011-6