Effect Of Anthonisen Type-Based Guidelines VS PCT-Based Guidelines On Antibiotic Use In AECOPD

ObjectiveTo compare the effect of Anthonisen type-based guidelines with PCT level on guiding the optimized utilization of antibiotics in patients with acute exacerbation of chronic obstructive pulmonary disease（AECOPD）.Investigated the value of PCT,and evaluated PCT can become a laboratory indicator to guide the reasonable use of antibiotics in AECOPD.Methods120 patients with AECOPD in a hospital of Huizhou from December 2012 to December 2014 were randomized into conventional treatment group（n=60）and PCT group（n=60）.Starting antimicrobial therapy depend on each indication.Observe serum superoxide dismutase（SOD）,malonaldehyde（MDA）,total antioxidant capacity（T-AOC）,interleukin-6（IL-6）,interleukin-8（IL-8）,tumor nectosis factor-alpha（TNF-α）,forced expiratory volume in 1 second（FEV₁）,FEV1/FVC and FEV₁ predicated value proportion（FEV₁%pred）.Hospitalization stay,duration of antibiotics use,time to next exacerbation,half-year exacerbation times and deaths were recorded.Results1.The cure rate in PCT group was higher than in Anthonisen group（P<0.05）,while the total effective rate in two groups was no statistically significance（P>0.05）.2.Before the treatment,the levels of oxidative stress,lung function,inflammatory-cytokines in two groups were no statistically significance（P>0.05）.The levels of MDA,inflammatory cytokines in two groups were reduced while SOD,T-AOC and lung function were rised after the treatment（P<0.05）.3.In PCT group,hospitalization and duration of antibiotics use were shorter,while the incidence rate of half-year readmission,hospital mortality and half-year mortality were lower,time to next exacerbation were longer,which were significant difference between two groups（P<0.05）.ConclusionsPCT level could guild reducing antibiotic use on AECOPD patients.As a laboratory indicator,PCT is proved to be a higher guidance value in optimizing the use of antimicrobials.