Evidence map›Paper›PMID 28143877›Full record

SynthesisEuropean respiratory review : an official journal of the European Respiratory Society2017

Procalcitonin to guide antibiotic administration in COPD exacerbations: a meta-analysis.

Alexander G Mathioudakis, Victoria Chatzimavridou-Grigoriadou, Alexandru Corlateanu, Jørgen Vestbo

2 registry-linked trialsOpen access · diamondAbstract readMeta-AnalysisReview
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in European respiratory review : an official journal of the European Respiratory Society, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 57 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 5 pooled it
11.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03440060 naunknown statusnot on this map

Procalcitonin-guided Antibiotic Therapy During Severe Exacerbation of COPD Requiring Mechanical Ventilation: a Controlled Randomized Trial

TypeinterventionalSponsorUniversity Hospital, MahdiaRan2017 to 2020Enrolled100ConditionsAcute Exacerbation CopdArmsprocalcitonin
NCT06514599 completednot on this mapstarted 2023, after this paper: background citation

Comparison of The Efficacy of CRP, Procalcitonin and Pro-BNP as Diagnostic and Prognostic Markers in AECOPD

Typeobservational_patient_registrySponsorKanuni Sultan Suleyman Training and Research HospitalRan2023 to 2024Enrolled196ConditionsCOPD Exacerbation Acute
3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 5 syntheses or guidelines pooled it, 127 citations in OpenAlex.

  1. Mucolytics for acute exacerbations of chronic obstructive pulmonary disease: a meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2023
    Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Antibiotics for exacerbations of chronic obstructive pulmonary disease.The Cochrane database of systematic reviews · 2018
    Pooled it
  6. Trial
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
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  14. Early detection and prediction of acute exacerbation of chronic obstructive pulmonary disease.Chinese medical journal pulmonary and critical care medicine · 2023
    Review
  15. Review
  16. Review
  17. Article
  18. Review
  19. Utility of Procalcitonin in Clinical Practice.Journal of Brown hospital medicine · 2023
    Review
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors at 3 institutions in 3 countries.

Alexander G MathioudakisDivision of Infection, Immunity and Respiratory Medicine, University Hospital of South Manchester, University of Manchester, Manchester, UK.
Victoria Chatzimavridou-GrigoriadouRespiratory Department, General Hospital of Nikaia St Panteleimon, Piraeus, Greece.
Alexandru CorlateanuDepartment of Respiratory Medicine, State University of Medicine and Pharmacy "Nicolae Testemitanu", Chisinau, Moldova.
Jørgen VestboDivision of Infection, Immunity and Respiratory Medicine, University Hospital of South Manchester, University of Manchester, Manchester, UK Jorgen.Vestbo@manchester.ac.uk.
University of Manchester · GBGeneral Hospital of Nikea · GRNicolae Testemițanu State University of Medicine and Pharmacy · MD

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD. We followed Cochrane and GRADE (Grading of Recommendations, Assessment, Development and Evaluation) guidance to assess risk of bias, quality of evidence and to perform meta-analyses.We included eight trials evaluating 1062 patients with AECOPD. Procalcitonin-based protocols decreased antibiotic prescription (relative risk (RR) 0.56, 95% CI 0.43-0.73) and total antibiotic exposure (mean difference (MD) -3.83, 95% CI (-4.32--3.35)), without affecting clinical outcomes such as rate of treatment failure (RR 0.81, 0.62-1.06), length of hospitalisation (MD -0.76, -1.95-0.43), exacerbation recurrence rate (RR 0.96, 0.69-1.35) or mortality (RR 0.99, 0.58-1.69). However, the quality of the available evidence is low to moderate, because of methodological limitations and small overall study population.Procalcitonin-based protocols appear to be clinically effective; however, confirmatory trials with rigorous methodology are required.

Indexed as

Anti-Bacterial AgentsBiomarkersCalcitoninChi-Square DistributionDisease ProgressionDrug Administration ScheduleHumansOdds RatioPatient ReadmissionPatient SelectionPredictive Value of TestsPulmonary Disease, Chronic ObstructiveRespiratory Tract InfectionsRisk FactorsTreatment OutcomeUnnecessary ProceduresAnti-Bacterial AgentsBiomarkersCalcitonin

Identifiers

PMID28143877
PMCPMC9488925
OpenAlexW2585074597

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.