Porcalcitonin-guided VS Anthonisen Type-based Antibiotic Regime In Acute Exacerbations Of Chronic Obstructive Pulmonary Disease

Objective To investigate the clinical value of serum procalcitonin PCT-basedantibiotic regime in exacerbations of chronic obstructive pulmonary disease(AECOPD）.Methods Ninety patients with AECOPD were randomized to the PCTgroup and the control group. Serum PCT levels in patients from the PCT group weremeasured2h within admission and every72hours thereafter. Antibiotics were withheldor discontinued when PCT<0.1μg/L, and initiated or continued while PCT≥0.1μg/L.Antibiotic treatment in the control group was initiated based on Anthonisen typeaccording to the GOLD2006guideline and was suspended after clinical stabilitysustained for2days.Results The duration of antibiotic therapy and hospitalizationwas (5.2±1.4) and (9.2±2.4) days in the PCT group,(8.2±2.5) and (10.4±2.8) days inthe control group (both P<0.05). The clinical effective rate, exacerbation times andtime to next exacerbation was not significant between both groups. The1-yearhospitalization rate was1.3±0.6in the PCT group, significantly lower than that in thecontrol group (1.6±0.5, t=2.387, P=0.022). One-year ΔFEV1in the PCT group and thecontrol group was20.3(-73.4~124.2)ml and18.1(-103.2~88.9) ml (P>0.05).Conclusion PCT-guided antibiotic regime reduces antibiotic use in moderate AECOPDpatients.