Source: Annual Congress 2008 - Factors related to outcome of community-acquired pneumonia
Disease area: Respiratory infections

Abstract

Background: Inflammatory markers are used in the diagnosis and risk stratification of community acquired pneumonia (CAP). However, there is almost no data about the influence of antibiotic pre-treatment (APT) on levels of inflammatory markers. Aim of this CAPNETZ substudy was to investigate if APT influences inflammatory markers in CAP.
Methods: We enrolled 965 pts (63 ± 18 y., 61 % m) that had to be hospitalized because of CAP. In all pts procalcitonin (PCT), C-reactive protein (CRP) and leukocyte count (WBC) were determined. Pts were followed-up for 28 days for survival.
Results: 244 pts had a pre-treatment with antibiotics, 721 had no APT. Pts without APT had higher levels of PCT (4.53 ± 26.01 vs. 0.96 ± 4.76 ng/ml, p < 0.0001) and WBC (13.9 ± 6.6 vs. 12.4 ± 6.0 G/l, p < 0.0005) but not of CRP (140 ± 124 vs. 134 ± 116 mg/ml, n.s.) compared to those with APT. In patients without APT survivors compared to non-survivors had lower values of PCT (3.26 ± 15.24 vs. 19.95 ± 78.50 ng/ml, p < 0.0001), WBC (13.6 ± 6.3 vs. 16.4 ± 9.2 G/l, p < 0.05) and CRP (136 ± 121 vs. 197 ± 144 mg/ml, p < 0.005). In patients with APT survivors and non-survivors had comparable values of PCT (1.06 ± 5.36 vs. 0.85 ± 1.81 ng/ml, n.s.), WBC (12.3 ± 6.1 vs. 12.6 ± 6.8 G/l, n.s.) and CRP (132 ± 119 vs. 160 ± 105 mg/ml, n.s.).
Conclusion: APT influences levels of inflammatory markers in CAP. Pts without APT had higher levels of PCT and WBC but not of CRP compared to those with APT. In patients without APT survivors compared to non-survivors had lower values of PCT, WBC and CRP. However, in patients with APT survivors and non-survivors had comparable values of PCT, WBC and CRP.

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Citations should be made in the following way:
S. Krueger, J. Kunde, A. Hanschmann, R. Marre, N. Suttorp, T. Welte (Aachen, Hennigsdorf, Ulm, Berlin, Hannover, Germany). Influence of antibiotic pre-treatment on inflammatory markers in community-acquired pneumonia. Eur Respir J 2008; 32: Suppl. 52, 1558

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