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Antibiotics for Bronchitis, COPD: Procalcitonin Validated as Decision Guide

June 15, 2012

FEATURED SEARCH TERM:  bronchitis

 

A procalcitonin-based algorithm for antibiotic treatment of lower respiratory tract infection has been validated in several randomized trials, but does this hold true in the real world of clinical practice? Researchers from Harvard's School of Public Health have tested the question in real-life clinical situations including hospitals and general practice. The results validate the efficacy of the "antibiotic stewardship" strategy. The algorithm is included in this free full-text report.

RESULT: Effectiveness and Safety of Procalcitonin-Guided Antibiotic Therapy in Lower Respiratory Tract Infections in “Real Life”
Archives of Internal Medicine | May 14, 2012 (FREE FULL TEXT)

 

As a low-tech "biomarker" for the first pass, check whether the sputum is yellow, green, red, or clear. In a pooled analysis of data from six multicenter studies of patients with acute exacerbations of chronic bronchitis, these researchers found sputum color to be better than other physicological indicators including dyspnea and fever, at judging whether chronic bronchitis is due to a bacterial infection. (But it's not good enough to guide decision-making about antibiotics, they conclude.)

RESULT:  Sputum colour and bacteria in chronic bronchitis exacerbations: a pooled analysis
European Respiratory Journal | May 31, 2012 (Free abstract. Full text $15)

 

How often are antibiotics justified to prevent disability and dyspnea in chronic bronchitis? The Cochrane Collaboration has recently weighed in on the question with a meta-analysis.

RESULT:  Prophylactic antibiotic therapy for chronic bronchitis
Cochrane Summaries | Nov 9, 2011 (FREE FULL TEXT)

 

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