Influence of steroids on procalcitonin and C-reactive protein in patients with COPD and community-acquired pneumonia

Infection. 2008 Mar;36(2):163-6. doi: 10.1007/s15010-007-7206-5. Epub 2008 Mar 12.


Background: The induction of C-reactive Protein (CRP) may be attenuated by corticosteroids, whereas Procalcitonin (PCT) appears to be unaltered. We investigated, whether in community-acquired pneumonia (CAP) a combined antibiotic-corticosteroid therapy may actually lead to different slopes of decline of these inflammatory markers.

Patients and methods: We studied the slopes of decline of PCT and CRP serum levels during 7 consecutive days as well as clinical parameters in a group of patients with CAP on or off corticosteroids. Patients with underlying COPD received systemic corticosteroids (n = 10), while non-COPD patients (n = 10) presenting with CAP alone formed the control group. All patients were treated with antibiotics.

Results: At baseline, relevant clinical and laboratory characteristics of the two groups were similar. Regarding the decreasing shapes of the curves from PCT and CRP, no significant differences were found (p-value = 0.48 for the groups for CRP, respectively 0.64 for PCT). All patients showed an uneventful recovery.

Conclusion: In patients with COPD and CAP, the time courses over 7 days of PCT and CRP showed a nearly parallel decline compared to non-COPD patients with CAP. Contrary to the induction phase, corticosteroids do not modify the time-dependent decay of PCT and CRP when the underlying infectious disease (CAP) is adequately treated.

Publication types

  • Clinical Trial
  • Multicenter Study

MeSH terms

  • Aged
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • C-Reactive Protein / metabolism*
  • Calcitonin / blood*
  • Calcitonin Gene-Related Peptide
  • Community-Acquired Infections / blood
  • Community-Acquired Infections / complications
  • Community-Acquired Infections / drug therapy
  • Drug Therapy, Combination
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Methylprednisolone / therapeutic use*
  • Middle Aged
  • Pilot Projects
  • Pneumococcal Infections / drug therapy
  • Pneumonia / blood
  • Pneumonia / complications
  • Pneumonia / drug therapy*
  • Prednisone / therapeutic use*
  • Protein Precursors / blood*
  • Pulmonary Disease, Chronic Obstructive / blood
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / drug therapy*


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents
  • CALCA protein, human
  • Protein Precursors
  • Calcitonin
  • C-Reactive Protein
  • Calcitonin Gene-Related Peptide
  • Prednisone
  • Methylprednisolone