Effects of procalcitonin-guided treatment on antibiotic use and need for mechanical ventilation in patients with acute asthma exacerbation: Meta-analysis of randomized controlled trials

Wanis H. Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O. Saleh, Rayaz Malik

Research output: Contribution to journalArticle

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Abstract

Objective The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility or emergency department, or during hospital admission. The secondary outcome was the need for mechanical ventilation. Methods An extensive literature search was performed to identify randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate, or severe acute asthma exacerbations. Results Four randomized controlled trials evaluating 457 patients were included in this meta-analysis, with significant homogeneity observed among these studies. Procalcitonin-based protocols decreased antibiotic prescriptions (relative risk 0.58, 95% confidence interval 0.50–0.67). The conclusion regarding the difference between the two groups in the need for mechanical ventilation (relative risk 1.10, 95% confidence interval 0.62–1.94) was guarded due to inadequate power and the potential for type II error. The overall quality of evidence was also limited by the lack of double-blinding. Conclusions These data suggest a potential benefit for the use of serum procalcitonin in guiding antibiotic therapy in patients with an acute asthma exacerbation and advocates the need for more randomized controlled trials.

Original languageEnglish
Pages (from-to)75-80
Number of pages6
JournalInternational Journal of Infectious Diseases
Volume65
DOIs
Publication statusPublished - 1 Dec 2017

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Calcitonin
Artificial Respiration
Meta-Analysis
Asthma
Randomized Controlled Trials
Anti-Bacterial Agents
Therapeutics
Serum
Confidence Intervals
Prescriptions
Hospital Emergency Service
Primary Health Care
Physicians

Keywords

  • Antibiotic
  • Asthma
  • Exacerbation
  • Guided
  • Procalcitonin

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

Cite this

Effects of procalcitonin-guided treatment on antibiotic use and need for mechanical ventilation in patients with acute asthma exacerbation : Meta-analysis of randomized controlled trials. / Ibrahim, Wanis H.; Mushtaq, Kamran; Raza, Tasleem; Kartha, Anand; Saleh, Ahmed O.; Malik, Rayaz.

In: International Journal of Infectious Diseases, Vol. 65, 01.12.2017, p. 75-80.

Research output: Contribution to journalArticle

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