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Pradeesh Sivapalan1, Josefin Eklöf1, Barbara Bonnesen1

  • 1Lungemedicinsk Afdeling, Afdeling for Medicinske Sygdomme, Københavns Universitetshospital - Herlev og Gentofte Hospital.

Ugeskrift for Laeger
|April 12, 2024
PubMed
Summary

Personalized biomarker guidance for chronic obstructive pulmonary disease (COPD) exacerbations optimizes steroid and antibiotic use. This approach reduces medication side effects and combats antibiotic resistance.

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Area of Science:

  • Pulmonology
  • Clinical Medicine
  • Pharmacology

Background:

  • Chronic obstructive pulmonary disease (COPD) exacerbations require careful management to minimize morbidity and mortality.
  • Current treatment paradigms for COPD exacerbations often involve systemic corticosteroids and antibiotics, raising concerns about potential side effects and antimicrobial resistance.

Approach:

  • This review examines the role of biomarker-guided therapy in optimizing the use of systemic corticosteroids and antibiotics during COPD exacerbations.
  • Focus is placed on eosinophil counts for guiding corticosteroid administration and procalcitonin levels for informing antibiotic prescribing.

Key Points:

  • Eosinophil-guided therapy has demonstrated a reduction in systemic corticosteroid utilization, potentially mitigating associated adverse effects.
  • Procalcitonin-guided therapy has been shown to decrease unnecessary antibiotic consumption, thereby addressing the growing issue of antibiotic resistance.
  • Randomized controlled trials support the efficacy and safety of these personalized biomarker-based treatment strategies.

Conclusions:

  • Biomarker-guided approaches offer a promising strategy for enhancing the management of COPD exacerbations.
  • Personalized treatment based on biomarkers can lead to reduced medication exposure, fewer side effects, and a more judicious use of antibiotics.
  • Implementing these strategies can improve patient outcomes and contribute to antimicrobial stewardship efforts in COPD care.

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