Influence of Steroids on Procalcitonin and C-reactive Protein in Patients with COPD and Community-acquired Pneumonia

• DOI: 10.1007/s15010-007-7206-5
• Publication Date: 2008-03-10T10:25:29Z
• Authors: A. Perren; B. Cerutti; M. Lepori; V. Senn; B. Capelli; F. Duchini; G. Domenighetti
• Keywords: Calcitonin; Male; Community-Acquired Infections/blood/complications/drug therapy; Calcitonin Gene-Related Peptide; Anti-Inflammatory Agents; Prednisone/therapeutic use; Pilot Projects; Anti-Inflammatory Agents/therapeutic use; Methylprednisolone; Pneumococcal Infections; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; Pneumococcal Infections/drug therapy; Humans; ddc:610; Longitudinal Studies; Methylprednisolone/therapeutic use; Protein Precursors; info:eu-repo/classification/ddc/610; Aged; Protein Precursors/blood; C-Reactive Protein/metabolism; Pulmonary Disease, Chronic Obstructive/blood/complications/drug therapy; Pneumonia; Middle Aged; Calcitonin/blood; Anti-Bacterial Agents; 3. Good health; Community-Acquired Infections; Anti-Bacterial Agents/therapeutic use; C-Reactive Protein; Pneumonia/blood/complications/drug therapy; Prednisone; Drug Therapy, Combination; Female

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.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.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.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.