Eosinopenia as a biomarker for antibiotic use in COPD exacerbations: protocol for a retrospective hospital-based cohort study

Yang, Mei; Liu, Xuemei; Hu, Qiongqiong; Liu, Jun-Jie; Fu, Sijia; Chen, Daohong; Wu, Yanqing; Luo, Ai; Zhang, Xiawei; Feng, Ruizhi; Xu, Guangming; Liu, Can; Jiang, Hongli; Liu, Wei

doi:10.1136/bmjopen-2021-051939

Cited by 3 publications

(3 citation statements)

References 54 publications

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“…This may explain the lower specificity of the CIBLE score > 87. However, as corticosteroid therapy is a frequent COPD treatment and is known to alter eosinophil count [ 35 , 36 ], this would have biased the results.…”

Section: Discussionmentioning

confidence: 99%

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

Mésinèle,

Pujol,

Brunetti

et al. 2023

BMC Geriatr

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Background The incidence of sepsis increases significantly with age, including a high incidence of bacterial infection in the old adults. Eosinopenia and the CIBLE score have been proposed in critically ill adults and in internal medicine wards. This study aimed to assess whether a low eosinophil count was associated with acute bacterial infection among hospitalized older adults, and to find the most efficient eosinophil count cut-off to differentiate acute bacterial infection from other inflammatory states. Methods This was a prospective study from July 2020 to July 2022 in geriatric wards of the University Paul Brousse Hospital (Villejuif, France) including patients aged of 75 y/o or over suffering from fever or biological inflammation. Acute bacterial infection was assessed using biological identification and/or clinical and radiological data. Results A total of 156 patients were included. Eighty-two (53%) patients suffered from acute bacterial infection (mean age (SD) 88.7 (5.9)). Low eosinophil count was independently associated with acute bacterial infection: OR [CI95%] 3.03 [1.04–9.37] and 6.08 [2.42–16.5] for eosinophil count 0–0.07 G/L and 0.07–0.172 G/L respectively (vs. eosinophil count > 0.172 G/L). Specificity and sensitivity for eosinophil count < 0.01 G/L and CIBLE score were 84%-49% and 72%-62%, respectively with equivalent AUCs (0.66 and 0.67). Conclusion Eosinophil count < 0.01 G/L is a simple, routinely used and inexpensive tool which can easily participate in antibiotic decisions for older adults. Further studies are needed to assess clinical benefits. Trial registration The study was registered at Clinical trial.gov (NCT04363138–23/04/2020).

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Section: Discussionmentioning

confidence: 99%

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

Mésinèle,

Pujol,

Brunetti

et al. 2023

BMC Geriatr

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“…Many suffering from COPD, rely on prescribed or over-the-counter antibiotics for treatment. However, the non-controlled use of antibiotics to treat COPD in clinical settings has often resulted in increased treatment failures, bacterial resistance, and even increased chances of relapse [ 13 ].…”

Section: Penicillin As a Gift To War-torn Chinamentioning

confidence: 99%

Antibiotic Culture: A History of Antibiotic Use in the Second Half of the 20th and Early 21st Century in the People’s Republic of China

Zhou

2023

Antibiotics

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Antimicrobial resistance is now widely regarded as a global public health threat. A growing number of studies suggest that antibiotic resistance is higher in China than in most western countries. Despite the current official regulation prohibiting pharmacies from the unrestricted selling of antibiotics, there is little sign of declining consumer demand. China now ranks as the second largest consumer of antibiotics in the world, after India. Drawing on published historical data, unpublished archival documents, and recently collected oral interviews, this paper provides a historical overview of antibiotic use and abuse in the People’s Republic of China (PRC) from the second half of the 20th century to the present. It demonstrates how the political demand for health improvement, along with the state-sponsored popularization of allopathic medicine, on the one hand, and the lack of access to adequate medical care for the majority of the population, as well as the existing culture of self-medication, on the other hand, are working in tandem to create antibiotic dependency in China. In addition, the privatization and marketization of biomedicine and health care in post-Mao China have helped to build a new and ever-thriving network of production, distribution, and marketing of antibiotics, which has often proven difficult for the authorities to monitor. At the same time, increased purchasing power and easier accessibility created by this new network of production, distribution, and marketing have further contributed to the prevalence of antibiotic overuse in the late 20th and early 21st centuries.

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“…This may explain the lower speci city of the CIBLE score > 87. However, as corticosteroid therapy is a frequent COPD treatment and is known to alter eosinophil count (33,34), which would have biased the results.…”

Section: Population Descriptionmentioning

confidence: 99%

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

Mésinèle,

Pujol,

Brunetti

et al. 2023

Preprint

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BACKGROUND: The incidence of severe sepsis increases significantly with age: less than 5/1000 when aged from 50 to 54 years old (y/o) vs more than 25/1000 when aged 85 y/o and older. Eosinopenia and the CIBLE score have been proposed in critically ill adults and in internal medicine wards. This study aimed to assess whether a low eosinophil count is associated with acute bacterial infection among a hospitalized older adults population, and to find the most efficient eosinophil count cut-off to differentiate acute bacterial infection from other inflammatory states. METHODS: This is a prospective study from July 2020 to July 2022 in geriatric wards of the University Paul Brousse Hospital (Villejuif, France) including patients aged ≥ 75 y/o suffering from fever or biological inflammation. Acute bacterial infection was assessed using the French Society of Infectious Diseases guidelines. RESULTS: A total of 156 patients were included. Eighty-two (53%) patients suffered from acute bacterial infection (mean age (SD) 88.7 (5.9)). Low eosinophil count was independently associated with acute bacterial infection: OR [CI95%] 3.03 [1.04 – 9.37] and 6.08 [2.42 – 16.5] for eosinophil count 0 – 0.07 G/L and 0.07 – 0.172 G/L respectively (vs eosinophil count > 0.172 G/L). Specificity and sensitivity for eosinophil count < 0.01 G/L and CIBLE score were 84%-49% and 72%-62%, respectively with equivalent AUCs (0.66 and 0.67). CONCLUSION: Eosinophil count < 0.01 G/L is a simple, routinely used and inexpensive tool which can easily participate in antibiotic decisions for older adults. Further studies are needed to assess clinical benefits. Trial registration: The study was registered at Clinical trial.gov (NCT04363138 - 23/04/2020)

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Eosinopenia as a biomarker for antibiotic use in COPD exacerbations: protocol for a retrospective hospital-based cohort study

Cited by 3 publications

References 54 publications

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

Antibiotic Culture: A History of Antibiotic Use in the Second Half of the 20th and Early 21st Century in the People’s Republic of China

Association between low eosinophil count and acute bacterial infection, a prospective study in hospitalized older adults

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