{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,23]],"date-time":"2026-01-23T09:56:08Z","timestamp":1769162168738,"version":"3.49.0"},"reference-count":32,"publisher":"European Respiratory Society (ERS)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2012,2,1]]},"published-print":{"date-parts":[[2012,12]]},"abstract":"<jats:p>In patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) needing hospitalisation, sputum purulence is associated with bacteria in the lower respiratory tract. We performed a prospective non-randomised interventional pilot study applying a sputum purulence-guided strategy of antibiotic treatment and investigating the relationship between sputum purulence and biomarkers.<\/jats:p><jats:p>In hospitalised patients with acute exacerbation of COPD antibiotics were restricted to those with purulent sputum. The primary end-point was rate of therapeutic failure during hospitalisation. Secondary end-points were parameters reflecting short- and long-term outcomes.<\/jats:p><jats:p>We included 73 patients, 34 with non-purulent sputum. No differences were observed on therapeutic failure criteria (9% non-purulent<jats:italic>versus<\/jats:italic>10% purulent (p=0.51)). Serum C-reactive protein (CRP) was significantly increased in the purulent group at admission (11.6<jats:italic>versus<\/jats:italic>5.3, p=0.006) and at day 3 (2.7<jats:italic>versus<\/jats:italic>1.2, p=0.01). Serum procalcitonin (PCT) was similar between the groups. No differences were found in short-term outcomes. The exacerbation rate at 180 days was higher in the purulent group.<\/jats:p><jats:p>These results support the hypothesis of performing a randomised trial using a sputum purulence-guided antibiotic treatment strategy in patients with acute exacerbations of COPD. CRP, but not PCT, may be a useful parameter to increase confidence of the absence of bacterial bronchial infection.<\/jats:p>","DOI":"10.1183\/09031936.00150211","type":"journal-article","created":{"date-parts":[[2012,4,21]],"date-time":"2012-04-21T03:04:14Z","timestamp":1334977454000},"page":"1344-1353","source":"Crossref","is-referenced-by-count":62,"title":["Sputum purulence-guided antibiotic use in hospitalised patients with exacerbations of COPD"],"prefix":"10.1183","volume":"40","author":[{"given":"N\u00e9stor","family":"Soler","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariano","family":"Esperatti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Santiago","family":"Ewig","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arturo","family":"Huerta","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carlos","family":"Agust\u00ed","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antoni","family":"Torres","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"81","published-online":{"date-parts":[[2012,4,20]]},"reference":[{"key":"2024102021075141000_40.6.1344.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61382-8"},{"key":"2024102021075141000_40.6.1344.2","doi-asserted-by":"publisher","DOI":"10.1136\/thx.2005.040527"},{"key":"2024102021075141000_40.6.1344.3","doi-asserted-by":"publisher","DOI":"10.1136\/thorax.57.10.847"},{"key":"2024102021075141000_40.6.1344.4","doi-asserted-by":"crossref","first-page":"894","DOI":"10.7326\/0003-4819-144-12-200606200-00006","article-title":"Quality of care for patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease","volume":"144","author":"Lindenauer","year":"2006","journal-title":"Ann Intern Med"},{"key":"2024102021075141000_40.6.1344.5","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.165.8.891"},{"key":"2024102021075141000_40.6.1344.6","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa012561"},{"key":"2024102021075141000_40.6.1344.7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200709-1413OC"},{"key":"2024102021075141000_40.6.1344.8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0800353"},{"key":"2024102021075141000_40.6.1344.9","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3109\/02813439209014027","article-title":"Amoxicillin in treatment of acute uncomplicated exacerbations of chronic bronchitis. 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