ABSTRACT
BACKGROUND/AIM: There has been growing interest in the use of serum procalcitonin (PCT) and C-reactive protein (CRP) in patients with community-acquired pneumonia (CAP). The aim of this study was to investigate whether an assessment of fever, leukocyte count, and serum CRP and PCT levels on admission and during follow-up (day 3) provides any information about the clinical outcome in hospitalized patients with CAP. MATERIALS AND METHODS: Patients with a diagnosis of CAP who were admitted to and followed at four university hospitals were evaluated retrospectively using the Turkish Thoracic Society Pneumonia Database. RESULTS: A total of 103 hospitalized CAP patients (57 males, mean age: 61.5 ± 16.7 years) were enrolled in the study. Treatment failure (TF) was observed in 20 patients (19.4%). Pneumonia Severity Index scores, serum CRP levels, and PCT levels on admission were significantly higher in the TF group. There were significant decreases in CRP and PCT levels between admission day and day 3 in the treatment success group. CONCLUSION: In patients with CAP, the body temperature and leukocyte count on admission do not predict outcome. Monitoring levels of CRP and PCT may be useful as a predictor of treatment outcome.
Subject(s)
Community-Acquired Infections , Adult , Aged , Biomarkers , C-Reactive Protein , Calcitonin , Calcitonin Gene-Related Peptide , Female , Humans , Kinetics , Male , Middle Aged , Prognosis , Protein PrecursorsABSTRACT
INTRODUCTION: Objective of this study is to compare the difference between the length of hospitalisation, cost of treatment and treatment outcome of patients diagnosed with community acquired pneumonia and treated with beta-lactam-macrolide combination or fluoroquinolone monotherapy, according to 2009 Turkish Thoracic Society (TTS) Guide of Diagnosis and Treatment of Community Acquired Pneumonia in Adults (TTSCAPG). PATIENTS AND METHODS: Patients diagnosed with community-acquired pneumonia (CAP) between November 2010 and November 2011 in our hospital were included. The data was entered into TTS pneumonia database. Cases were examined for their accordance with TTSCAPG. Clinical outcomes of the patients treated with beta-lactam-macrolide combination or fluoroquinolone, were compared. RESULTS: One hundred and fifty six patients diagnosed with community-acquired pneumonia were included. 67.3% of the patients were treated according to the guideline. Of the patients treated in accordance with the guideline, 86.7% were treated with beta-lactam-macrolide combination and 13.3% with fluoroquinolone. Of the patients treated with combination therapy, the treatment was effective in 77.7%, ineffective in 11.8% and 10.6% resulted in death; where as the patients treated with fluoroquinolone, the treatment was effective in 84.7%, ineffective in 15.4%, none of them resulted in death. CONCLUSION: Cases diagnosed with community-acquired pneumonia and treated according to the TTSCAPG guideline were evaluated for effectiveness of combination therapy versus fluoroquinolone; no statistically difference in terms of age, diseases, length of stay, treatment outcomes, cost of treatment could be established. There was only a numerical difference between mortality outcomes of the two antibiotherapy groups compared, however the statistical difference was not significant.
