Thoracic Research and Practice
Original Article

Peripheral Blood Eosinophilia and Neutrophil Lymphocyte Ratio in the Choice of Antibiotic and/or Steroid in Patients Hospitalized with Acute Exacerbations of Chronic Obstructive Pulmonary Disease

1.

University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey

2.

Respiratory Intensive Care Unit, University of Health Sciences Süreyyapaşa Chest Diseases and Thoracic Surgery Training and Research Hospital, İstanbul, Turkey

Thorac Res Pract 2023; 24: 220-227
DOI: 10.5152/ThoracResPract.2023.21281
Read: 684 Downloads: 250 Published: 01 July 2023

OBJECTIVE: The choice of steroids and antibiotics is optional for the management of acute exacerbation of chronic obstructive pul- monary diseases according to international guidelines. The study hypothesized that the steroid and antibiotic choice can be decided by using the neutrophil–lymphocyte ratio and peripheral blood eosinophilia in patients with acute exacerbation of chronic obstructive pulmonary diseases. This would reduce the rate of re-hospitalization in 28 days.

MATERIAL AND METHODS: Patients were hospitalized due to acute exacerbation of chronic obstructive pulmonary diseases from February 1, 2018, to January 31, 2019. Patients were divided into 2 groups: Sureyyapasa protocol group and conventional group. In the Sureyyapasa protocol group, patients were divided into 4 subgroups according to peripheral blood eosinophilia and neutrophil–lympho- cyte ratio values. Treatment success was defined as 5-7 days acute exacerbation of chronic obstructive pulmonary diseases treatment was enough to discharge and no re-hospitalization within 28 days. Treatment failure was defined that the hospital stay was longer than 7 days or transport to intensive care and death or readmission to the hospital due to acute exacerbation of chronic obstructive pulmonary diseases within 28 days after discharge.

RESULTS: The Sureyyapasa protocol group (n = 96) and the conventional group (n = 95) were randomly selected. The conventional group and Sureyyapasa protocol group had similar hospital stay (P = .22), and antibiotic and steroid uses were significantly higher in the conventional group than the Sureyyapasa protocol group (antibiotic use 100% vs. 83%, P < .001 and steroid use 84% vs. 29%, P < .001, respectively). Treatment failure in the conventional Group (n = 23, 24%) is higher than the Sureyyapasa protocol group (n = 17, 18%).

CONCLUSIONS: Initiating treatment by evaluating eosinophilia and neutrophil–lymphocyte ratio in patients with acute exacerbation of chronic obstructive pulmonary diseases in the ward reduces unnecessary antibiotic and steroid use and cost rates in hospitalizations.

Cite this article as: Köse Kabil N, Karakurt Z, Gündoğuş B, Güngör A, Akyüz K, Türker H. Peripheral blood eosinophilia and neutrophil lymphocyte ratio in the choice of antibiotic and/or steroid in patients hospitalized with acute exacerbations of chronic obstructive pulmonary disease. Thorac Res Pract. 2023;24(4):220-227.

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