Procalcitonin, erythrocyte sedimentation rate and C-reactive protein in acute pulmonary exacerbations of cystic fibrosis.

Abstract

Acute pulmonary exacerbations of cystic fibrosis (APECF) are a leading cause of morbidity and mortality among patients with cystic fibrosis (CF). APECF require frequent administration of antibiotics and subsequently lead to development of resistant organisms. The aim of this study was to identify inflammatory markers that may be help identify need for antibiotics and exacerbation as well as predict risk of exacerbations. A total of 17 patients were enrolled, and baseline erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and procalcitonin levels were obtained in addition to obtaining these levels during admissions for APECF. A total of 28 APECF were recorded. ESR and CRP significantly increased during exacerbation (P<.01 for both). Procalcitonin did not increase during exacerbations. Baseline elevations in ESR and CRP increased risk of an exacerbation (RR=2.3 and 4.5, respectively). ESR and CRP are useful markers for CF exacerbations, as levels rise with exacerbations. Baseline elevations in ESR and CRP were noted to show an increased risk for CF exacerbations. Procalcitonin, in contrast, is not a useful inflammatory marker.