C-reactive protein-guided antibiotic therapy and prognostic value in acute infective exacerbation of COPD

Acute exacerbations of chronic obstructive pulmonary disease (COPD) frequently result in excessive empirical antibiotic use despite heterogeneous infectious triggers. Therefore, it is of interest to evaluate C-reactive protein (CRP) -guided antibiotic therapy and its prognostic significance in 50 hospitalized patients with acute infective exacerbation. Antibiotics were initiated when CRP ≥50 mg/L, while lower values were managed conservatively unless deterioration occurred. Patients with elevated CRP demonstrated greater initial inflammatory and clinical severity, whereas those with lower CRP improved without antibiotics and without adverse outcomes. CRP-guided management reduced unnecessary antibiotic exposure and supported its utility as a biomarker for therapeutic decision-making and short-term prognosis.