Gaining insights into chronic obstructive pulmonary disease exacerbation through emerging biomarkers and the chronic obstructive pulmonary disease assessment test score.

Chronic obstructive pulmonary disease (COPD), a leading cause of mortality and morbidity, presents significant challenges, particularly with exacerbations, which drastically impact patients' health and healthcare costs. The Global Initiative for Chronic Obstructive Lung Disease guidelines recommend comprehensive assessments beyond spirometry, with the COPD assessment test (CAT) emerging as a pivotal tool. Despite its utility, the relationship between CAT scores and specific biomarkers during exacerbations remains unclear. Hence, this study aims to assess the correlation between the CAT score and specific circulating biomarkers. A cross-sectional study from August 2023 to January 2024 included 59 COPD patients with exacerbations who underwent pulmonary function tests and completed the CAT score assessment. The CAT score cut-off point was set at 20, where a CAT score <20 indicated a low impact on health status and a CAT score ≥20 indicated a high impact on health status. On the same day, measurements of neutrophils, leukocytes, eosinophils, C-reactive protein, and procalcitonin were conducted. Patients with CAT scores ≥20 had significantly higher levels of neutrophils (p=0.001), leukocytes (p=0.006), procalcitonin (p=0.010), and forced expiratory volume in the first second/forced vital capacity (p=0.002), but lower eosinophil levels (p=0.025). A positive correlation existed between total CAT score and neutrophils (p=0.001), leukocytes (p=0.000), and procalcitonin (p=0.010), while eosinophil levels showed a negative correlation (p=0.025). The spirometry parameters showed no correlation with the total CAT score. This study highlights the link between CAT and key inflammatory biomarkers, supporting the use of blood biomarkers to identify COPD patients at risk of exacerbations.

Prescription analysis emphasizing on medication adherence of antibiotics for lower respiratory tract infection.

Antibiotics are choice of drugs in patients with respiratory infections. Irrational use of antibiotics is an important public health issue faced on daily basis by the community and the individual. Keeping this in consideration, the current study investigates the prescription pattern of antibiotics in lower respiratory tract infection in general population.The objectives of the study include prescription pattern analysis of antibiotics for LRTIs in general population and to evaluate adherence to antibiotic treatment. This was a hospital based prospective observational study conducted between November 2021 to April 2022 in the department of general medicine and pediatrics. Compliance to various antibiotics was scrutinized by using MMAS 4 scale. Patient demographics, laboratory details, prescribed antibiotics, duration of hospital stay were gathered over a period of 6 months.A total of 200 patients were involved in the study, out of which 53% were males and 47% were females. A total of 2127 drugs were prescribed in 200 patients (10.6 drugs/prescription). Ceftriaxone was the most commonly used antibiotic followed by azithromycin and piperacillin/tazobactam. The most frequently diagnosed disease was Bronchopneumonia (41%) followed by A/E COPD (28%). Evaluation of medication adherence resulted in 58% high and 11% poor adherence. The number of antibiotics prescribed was found to be rational but prevalence of polypharmacy should be prevented. Medication adherence decreases as the frequency of antibiotic increases, so it is recommended to lower the frequency of drugs as possible to enhance the compliance.