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Influence of steroids on procalcitonin and C-reactive protein in patients with COPD and community-acquired pneumonia

Lepori, M.
Senn, V.
Capelli, B.
Duchini, F.
Published in Infection. 2008, vol. 36, no. 2, p. 163-6
Abstract BACKGROUND: The induction of C-reactive Protein (CRP) may be attenuated by corticosteroids, whereas Procalcitonin (PCT) appears to be unaltered. We investigated, whether in community-acquired pneumonia (CAP) a combined antibiotic-corticosteroid therapy may actually lead to different slopes of decline of these inflammatory markers. PATIENTS AND METHODS: We studied the slopes of decline of PCT and CRP serum levels during 7 consecutive days as well as clinical parameters in a group of patients with CAP on or off corticosteroids. Patients with underlying COPD received systemic corticosteroids (n = 10), while non-COPD patients (n = 10) presenting with CAP alone formed the control group. All patients were treated with antibiotics. RESULTS: At baseline, relevant clinical and laboratory characteristics of the two groups were similar. Regarding the decreasing shapes of the curves from PCT and CRP, no significant differences were found (p-value = 0.48 for the groups for CRP, respectively 0.64 for PCT). All patients showed an uneventful recovery. CONCLUSION: In patients with COPD and CAP, the time courses over 7 days of PCT and CRP showed a nearly parallel decline compared to non-COPD patients with CAP. Contrary to the induction phase, corticosteroids do not modify the time-dependent decay of PCT and CRP when the underlying infectious disease (CAP) is adequately treated.
Keywords AgedAnti-Bacterial Agents/therapeutic useAnti-Inflammatory Agents/therapeutic useC-Reactive Protein/metabolismCalcitonin/bloodCommunity-Acquired Infections/blood/complications/drug therapyDrug Therapy, CombinationFemaleHumansLongitudinal StudiesMaleMethylprednisolone/therapeutic useMiddle AgedPilot ProjectsPneumococcal Infections/drug therapyPneumonia/blood/complications/drug therapyPrednisone/therapeutic useProtein Precursors/bloodPulmonary Disease, Chronic Obstructive/blood/complications/drug therapy
PMID: 18330505
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PERREN, Andréas et al. Influence of steroids on procalcitonin and C-reactive protein in patients with COPD and community-acquired pneumonia. In: Infection, 2008, vol. 36, n° 2, p. 163-6. https://archive-ouverte.unige.ch/unige:1876

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Deposited on : 2009-06-02

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