The 2020 Global Initiative for Obstructive Lung Disease report indicates that the blood biomarker procalcitonin (PCT) may assist in guiding the initiation of antibiotics for chronic obstructive pulmonary disease (COPD) exacerbations.

The purpose of this study was to evaluate the strength of data for PCT to guide the prescription of antibiotics in COPD exacerbations. Our study shows that after excluding studies with high risk of bias, the PCT-based protocol may not significantly reduce the duration of antibiotic treatment.

The PCT-based protocol may increase the length of hospital stay for intensive care unit (ICU) patients. PCT has limited value in guiding antibiotic use in COPD exacerbation.