Lin Changyang, Pang Qiyuan
Department of Gerontology, Guizhou provincial people's hospital, Guiyang, China.
Clin Respir J. 2018 Jan;12(1):10-15. doi: 10.1111/crj.12519. Epub 2016 Jul 8.
To evaluate the method of procalcitonin (PCT)-guided treatment on antibiotics in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).
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.
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; I = 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.
Results from this meta-analysis suggest PCT-guided treatment can safely reduce antibiotic overuse in patients with AECOPD.
评估降钙素原（PCT）指导下的抗生素治疗方法对慢性阻塞性肺疾病急性加重期（AECOPD）的疗效。
检索包括PubMed、EMBASE和Cochrane对照试验中心注册库在内的数据库以查找相关试验。纳入PCT指导治疗成年AECOPD患者的随机和半随机试验。在这项荟萃分析中评估对主要结局（即抗生素处方、死亡率和临床成功率）的影响。
纳入了四项涉及679例患者的试验。与标准治疗相比，PCT指导治疗显著减少了抗生素的使用（比值比[OR]0.26，95%置信区间[CI]0.14 - 0.50，P < 0.0001），且未增加临床失败率（OR 1.10，95% CI 0.70 - 1.74，P = 0.68；I² = 0%）和死亡率（OR 0.86，95% CI 0.44 - 1.68，P = 0.66）。两组随访期的再入院率和病情加重率相似。
这项荟萃分析的结果表明，PCT指导治疗可安全减少AECOPD患者抗生素的过度使用。
