Guiding value of procalcitonin in rational antiobiotic therapy for the elderly with acute exacerbation of chronic obstructive pulmonary disease
Received:April 11, 2016  
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DOI:10.11915/j.issn.1671-5403.2016.10.187
Key words:acute exacerbation of chronic obstructive pulmonary disease  procalcitonin  antibiotics  treatment outcome
Author NameAffiliationE-mail
MA Li1, WEN Zhong-Guang2* 1Medical School of Chinese PLA, Beijing 100853, China
2Department of Respiratory Diseases, the First Affiliated Hospital of Chinese PLA General Hospital, Beijing 100037, China 
drmali2015@126.com 
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Abstract:
      Objective To evaluate the clinical value of monitoring the level of procalcitonin (PCT) in the elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) combined with bacterial infection. Methods A total of 140 elderly patients with AECOPD admitted in our hospital from July 2012 to January 2013 were enrolled in this study. They were randomly divided into the PCT guidance group (n=72) and the routine therapy group (n=68). On the basis of similar routine treatment, the patients of the PCT guidance group were treated with antibiotics according to their serum PCT level. While, for those in the routine therapy group, antibiotics were administered according to the physician’s clinical experiences combined with patient’s conditions. The duration of antibiotic therapy, clinical efficacy, costs of hospitalization and antibiotics, length of hospital stay, and inflammatory indices after antibiotic therapy[total white blood cell count (WBC) and C-reactive protein (CRP)] were compared between the two groups. Results There were no significant differences in the WBC count and CRP level between the 2 groups (P>0.05), but the PCT guidance group had obviously shorter length of hospital stay (P<0.01), and lower costs of hospitalization and antibiotics when compared with the routine therapy group (P<0.05). In addition, the PCT guidance group had obviously shorter duration of antibiotic therapy, when compared with the routine therapy group (P<0.01). Conclusion Using PCT level to guide the antibiotic treatment strategies will improve the efficacy of the antibiotics, avoid the unnecessary antibiotic exposure, shorten length of hospital stay and lower the costs of hospitalization and antibiotics in the treatment of the elderly patients with AECOPD.
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