Meta-analysis and systematic review of procalcitonin-guided treatment in acute exacerbation of chronic obstructive pulmonary disease

Clin Respir J. 2018 Jan;12(1):10-15. doi: 10.1111/crj.12519. Epub 2016 Jul 8.

Abstract

Introduction: To evaluate the method of procalcitonin (PCT)-guided treatment on antibiotics in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods: Database including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trails were searched to find relevant trails. Randomized and quasi-randomized trials of PCT-guided treatment in adult patients with AECOPD were included. Effects on primary outcome (i.e., antibiotic prescriptions, mortality, and clinical success) were accessed in this meta-analysis.

Results: Four trials involving 679 patients were included. PCT-guided treatment significantly reduced antibiotic use (OR 0.26, 95% CI 0.14-0.50, P < 0.0001) in comparison to standard treatment, without increasing clinical failure (OR 1.10, 95% CI 0.70-1.74, P = 0.68; I2 = 0%) and mortality (OR 0.86, 95% CI 0.44-1.68, P = 0.66). The rate of readmission and exacerbation at follow-up period was similar in both groups.

Conclusion: Results from this meta-analysis suggest PCT-guided treatment can safely reduce antibiotic overuse in patients with AECOPD.

Keywords: AECOPD; antibiotics; meta-analysis; procalcitonin.

Publication types

  • Meta-Analysis
  • Review
  • Systematic Review

MeSH terms

  • Calcitonin Gene-Related Peptide / therapeutic use*
  • Protein Precursors*
  • Pulmonary Disease, Chronic Obstructive / drug therapy*
  • Vasodilator Agents / therapeutic use

Substances

  • Protein Precursors
  • Vasodilator Agents
  • Calcitonin Gene-Related Peptide