Peran C-Reactive Protein Pada Eksaserbasi Penyakit Paru Obstruktif Kronik

Oleh :

dr. Hendra Gunawan SpPD

Pemeriksaan C-reactive protein (CRP) dianggap memiliki peran pada keputusan pemberian antibiotik untuk pasien penyakit paru obstruktif kronik (PPOK). Antibiotik banyak digunakan dalam tata laksana eksaserbasi akut penyakit paru obstruktif kronik (PPOK).[1]

Hingga saat ini, antibiotik masih merupakan obat yang paling sering diresepkan pada fasilitas kesehatan tingkat pertama. Hicks et al., melaporkan bahwa antibiotik yang paling sering digunakan adalah golongan penicillin dan makrolida. Akan tetapi, penggunaan antibiotik yang kurang rasional dapat meningkatkan risiko resistensi mikroba, terjadinya efek samping, dan mengubah flora normal tubuh.[1,2]

Penyakit paru obstruktif kronik (PPOK) adalah kondisi timbulnya gejala respirasi persisten akibat keterbatasan aliran udara paru karena adanya kelainan saluran napas atau alveoli.[3]

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Referensi

1. Hicks L, Bartoces M, Roberts R, Suda K, Hunkler R, Taylor TJ, et al. US outpatient antibiotic prescribing variation according to geography, patient population, and provider specialty in 2011. Clinical Infectious Disease. 2015;60(9):1308-16.
2. Butler CC, Gillespie D, White P, Bates J, Lowe R, Thomas-Jones E, et al. C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations. New England Journal of Medicine. 2019;2019(381):111-20.
3. Global Initiative for Chronic Obstructive Lung Disease. Global Strategy for the Diagnosis, Management, and Prevention of COPD. In: Global Initiative for Chronic Obstructive Lung Disease, editor. Pocket Guide to COPD Diagnosis, Management, and Prevention. Global Initiative for Chronic Obstructive Lung Disease. 2019. p. 2.
4. Global Initiative for Chronic Obstructive Lung Disease. Management of Exacerbations. In: Disease, GIfCOL, editor. Pocket Guide to COPD Diagnosis, Management, and Prevention. Global Initiative for Chronic Obstructive Lung Disease. 2019. p. 38.
5. Llor C, Bjerrum L, Munck A, Hansen M, Cordoba G, Strandberg E, et al. Predictors for antibiotic prescribing in patients with exacerbations of COPD in general practice. Therapeutic Advances in Respiratory Disease. 2013;7(3):131-7.
6. Van Velzen P, Ter Riet G, Bresser P, Baars J, van den Berg B, van den Berg J, et al. Doxycycline for outpatient-treated acute exacerbations of COPD: a randomised double-blind placebo-controlled trial. Lancet Respiratory Medicine. 2017;5(6):492-9.
7. Anthonisen N, Manfreda J, Warren C, Hershfield E, Harding G, Nelson N. Antibiotic Therapy in Exacerbations of Chronic Obstructive Pulmonary Disease. Annals of internal medicine. 1987;106(2):196-204.
8. Minnaard MC, van de Pol AC, de Groot JA, De Wit NJ, Hopstaken RM, van Delft S, et al. The Added Diagnostic Value of Five Different C-reactive Protein Point-Of-Care Test Devices in Detecting Pneumonia in Primary Care: A Nested Case-Control Study. Scandinavian Journal of Clinical Laboratory Investigation. 2015;75(4):291-5.
9. Leuzzi G, Galeone C, Taverna F, Suatoni P, Morelli D, Pastorino U. C-reactive protein level predicts mortality in COPD: a systematic review and meta-analysis. European Respiratory Review. 2017;2017(26):160070.
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11. Mathioudakis AG, Janner J, Moberg M, Alonso-Coello P, Vestbo J. A systematic evaluation of the diagnostic criteria for COPD and exacerbations used in randomised controlled trials on the management of COPD exacerbations. ERJ Open Res. 2019 Nov 15;5(4):00136-2019. doi: 10.1183/23120541.00136-2019. PMID: 31754621; PMCID: PMC6856493.