INTRODUCTION: Exacerbations of COPD can be precipitated by several factors. The most common causes appear to be respiratory tract infections. Overuse of antibiotics is common and accelerates the development of drug resistance
and hospital acquired infections. In some recent studies, both C-reactive protein as well as Procalcitonin levels have been shown to be useful in differentiating bacterial etiology of exacerbations and thus helping in guiding the treatment as well as
in prediction of outcome. Evaluate sensitivity and specificity of C-reactive protein and Procalcitonin as a marker of bacterial infection in patients with acute exacerbation of COPD. MATERIAL AND METHODS: The present hospital-based observational
study was carried out at Department of Pulmonary Medicine, SRMSIMS, Bareilly. 50 patients from patients of COPD with acute exacerbation attending/admitted to Pulmonary OPD/IPD were included in the study excluding those below 40yrs old or presenting
with acute breathlessness due to comorbid condition. Demographic information, relevant clinical data and lab investigations were recorded from all patients including C-reactive protein and Procalcitonin on admission following which the patients were
started antibiotics as per guidelines. Reassessment of S. Procalcitonin and C-reactive protein was done on 3rd and 7th day of hospitalization. ROC Curve was applied to compare sensitivity and specificity. RESULTS: Sputum culture was found positive in
27 (54.0%) patients. At all the three intervals, CRP levels had ROC area under curve (ROCAUC) values above 0.70. Area under curve value was maximum at day 3. For Procalcitonin, the area under curve values were >0.8 at day 1 and day 3 but on day 7
this value was only 0.624. On evaluating the correlation between S. C-Reactive Protein and Procalcitonin levels, a mild positive and significant correlation was observed at day 1 and day 7 intervals whereas on day 3 a moderate positive and
significant correlation was observed between the two markers.CONCLUSION: CRP is good marker when tested early and late while PCT is better when tested early.
Differences in plasma amino acid levels in patients with and without bacterial infection during the early stage of acute exacerbation of COPD
