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VOLUME 62 , ISSUE 2 ( April-June, 2020 ) > List of Articles

Original Article

Procalcitonin as a Diagnostic Marker in Patients of Acute Bacterial Exacerbation of Chronic Obstructive Pulmonary Disease

Amritesh Rajan Mishra, Ved Prakash, S.K. Verma, R.A.S. Kushwaha, S. Kumar, Anand Srivastava, D.K. Bajaj

Keywords : COPD, Procalcitonin, Acute bacterial exacerbation

Citation Information : Mishra AR, Prakash V, Verma S, Kushwaha R, Kumar S, Srivastava A, Bajaj D. Procalcitonin as a Diagnostic Marker in Patients of Acute Bacterial Exacerbation of Chronic Obstructive Pulmonary Disease. Indian J Chest Dis Allied Sci 2020; 62 (2):57-60.

DOI: 10.5005/ijcdas-62-2-57

License: CC BY-NC 4.0

Published Online: 07-11-2022

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Objective: Common factors for exacerbation of chronic obstructive pulmonary disease (COPD) are viral and bacterial infections. Presence of purulent sputum for the initiation of antibiotic therapy is non judicious because antibiotic usage in viral exacerbation may lead to the development of bacterial resistance and unnecessary economic burden on the patient. Procalcitonin (PCT) is a marker which can be used to differentiate between viral and bacterial causes as an aetiology of these exacerbations. Methods: Patients with exacerbation of COPD (increased dyspnoea, cough, increased sputum volume and/or purulence) were identified. Sputum culture was sent along with serum PCT levels. Patients were divided into two groups –Group I (COPD patients with bacterial exacerbation, confirmed by the sputum culture) and Group II (COPD patients without bacterial exacerbation). Serum PCT levels were measured in both the groups. Results: Results of the study revealed that PCT levels ranged from 0.01 to and 12.03 ng/mL with a mean value of 3.18±2.60 ng/mL in Group I and 0.23±0.39 ng/mL in Group II and median values of 2.98 ng/mL in Group I and 0.09 ng/mL in Group II. There was a statistically significant difference between the two groups (P<0.001) with Group I showing a higher mean values compared to Group II. A significant near strong correlation was observed between total leucocyte count and PCT levels (r=0.699; P<0.001). However, a weak negative and borderline significant correlation between forced expiratory volume in one second/forced vital capacity (FEV1/FVC) levels and PCT levels was observed (r=–0.199; P=0.050). Conclusion: Procalcitionin can be used to differentiate between bacterial and viral exacerbation of COPD. PCT- guided antibiotic therapy has a potential to decrease the unnecessary use of antibiotics and economic burden on the patient.


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