Study of serum procalcitonin level on the strategy value of antibiotic treatment in patients with acute exacerbation of chronic obstructive pulmonary disease

Objective To evaluate the value of serum procalcitonin level in guiding the optimization use of antibiotics in patients with acute exacerbation of chronic obstructive pulmonary disease.Methods From September 2006 to August 2007 in the department of geriatric respiratory medicine and the characteristic clinic Center of Respiratory disease,56 hospitalized acute exacerbation of chronic obstructive pulmonary disease(AECOPD) patients with serum PCT0.25 μg/L were randomized into PCT group (n=26) and conventional treatment group(n=30).In PCT group,at 1,5,7 and 10 day,Serum PCT level were assessed,patients received antibiotics according to the level of serum PCT,if PCT0.25 μg/L,antibiotics were suspended in conventional treatment group,patients received antibiotics according to the clinical experience of attending physicians.At the same time,the sputum bacteriology and other laboratory indicators such as white blood cell count,C-reactive protein were investigated.Days of antibiotics use and hospitalization,clinical efficiency,functional status score,the incidence of Secondary infection,the number of aggravated cases and deaths were analyzed.Results In PCT Group,the days of antibiotics use mostly distribute in 7-10 days and the conventional treatment group in two weaks and more longer,The difference was significant(P0.01),In two group,hospitalization(P0.01),and the incidence of secondary infection(P0.05) were significant different,the clinical efficiency,functional status score,mortality and aggravated cases in two groups was no significant difference(P0.05).Conclusions Serum procalcitonin level may serve as guidance for optimization use of antibiotics with AECOPD patients.