Effect Of Anthonisen Type-Based Guidelines VS PCT-Based Guidelines On Antibiotic Use In AECOPD

ObjectiveTo compare the effect of Anthonisen type-based guidelines with PCT level on guiding the optimized utilization of antibiotics in patients with acute exacerbation of chronic obstructive pulmonary disease?AECOPD?.Investigated the value of PCT,and evaluated PCT can become a laboratory indicator to guide the reasonable use of antibiotics in AECOPD.Methods120 patients with AECOPD in a hospital of Huizhou from December 2012 to December 2014 were randomized into conventional treatment group?n=60?and PCT group?n=60?.Starting antimicrobial therapy depend on each indication.Observe serum superoxide dismutase?SOD?,malonaldehyde?MDA?,total antioxidant capacity?T-AOC?,interleukin-6?IL-6?,interleukin-8?IL-8?,tumor nectosis factor-alpha?TNF-??,forced expiratory volume in 1 second?FEV₁?,FEV1/FVC and FEV₁ predicated value proportion?FEV₁%pred?.Hospitalization stay,duration of antibiotics use,time to next exacerbation,half-year exacerbation times and deaths were recorded.Results1.The cure rate in PCT group was higher than in Anthonisen group?P<0.05?,while the total effective rate in two groups was no statistically significance?P>0.05?.2.Before the treatment,the levels of oxidative stress,lung function,inflammatory-cytokines in two groups were no statistically significance?P>0.05?.The levels of MDA,inflammatory cytokines in two groups were reduced while SOD,T-AOC and lung function were rised after the treatment?P<0.05?.3.In PCT group,hospitalization and duration of antibiotics use were shorter,while the incidence rate of half-year readmission,hospital mortality and half-year mortality were lower,time to next exacerbation were longer,which were significant difference between two groups?P<0.05?.ConclusionsPCT level could guild reducing antibiotic use on AECOPD patients.As a laboratory indicator,PCT is proved to be a higher guidance value in optimizing the use of antimicrobials.