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Épisode 27 : Étude PACE

Traitement antibiotique guidé par la protéine C-réactive dans l’exacerbation aiguë de MPOC (étude PACE)

Diffusé le 19 septembre 2019

Dans cette 27e baladodiffusion, les Drs Luc Lanthier et Gabriel Huard discutent d’antibiothérapie guidée par la protéine C-réactive dans l’exacerbation aiguë de MPOC avec l’étude PACE, en plus de réviser la littérature médicale de juillet et août 2019.

Quiz clinique (2 min 17), article principal (2 min 42), critique (26 min 10), autres articles (31 min 32), réponse au quiz clinique (36 min 33)

Référence principale

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. N Engl J Med. 2019;381(2):111-20. PubMed PMID: 31291514.


Articles associés

Brett AS, Al-Hasan MN. COPD Exacerbations - A Target for Antibiotic Stewardship. N Engl J Med. 2019;381(2):174-175. PubMed PMID: 31291521.

Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. GOLD, 2019 (

O'Donnell DE, Aaron S, Bourbeau J, Hernandez P, Marciniuk DD, Balter M, Ford G, et al. Canadian Thoracic Society recommendations for management of chronic obstructive pulmonary disease - 2007 update. Can Respir J. 2007;14 Suppl B:5B-32B. PubMed PMID: 17885691.

Anthonisen NR, Manfreda J, Warren CP, Hershfield ES, Harding GK, Nelson NA. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med. 1987; 106(2):196-204. PubMed PMID: 3492164.

Sator L, Horner A, Studnicka M, Lamprecht B, Kaiser B, McBurnie MA, et al. Overdiagnosis of COPD in Subjects With Unobstructed Spirometry: A BOLD Analysis. Chest. 2019;156(2):277-88. PubMed PMID: 30711480.

Sivapalan P, Lapperre TS, Janner J, Laub RR, Moberg M, Bech CS, et al. Eosinophil-guided corticosteroid therapy in patients admitted to hospital with COPD exacerbation (CORTICO-COP): a multicentre, randomised, controlled, open-label, non-inferiority trial. Lancet Respir Med. 2019;7(8):699-709. PubMed PMID : 31122894.

Layden JE, Ghinai I, Pray I, Kimball A, Layer M, Tenforde M, et al. Pulmonary Illness Related to E-Cigarette Use in Illinois and Wisconsin - Preliminary Report. N Engl J Med. 2019. doi: 10.1056/NEJMoa1911614. PubMed PMID: 31491072.

Capsule méthodologique

Norton EC, Dowd BE, Maciejewski ML. Odds Ratios-Current Best Practice and Use. JAMA. 2018;320(1):84-85. PubMed PMID: 29971384.

Autres articles d'intérêt récents

Khan F, Rahman A, Carrier M, Kearon C, Weitz JI, Schulman S, et al. Long term risk of symptomatic recurrent venous thromboembolism after discontinuation of anticoagulant treatment for first unprovoked venous thromboembolism event: systematic review and meta-analysis. BMJ. 2019;366:l4363. PubMed PMID: 31340984.

Vascular Events in Noncardiac Surgery Patients Cohort Evaluation Study I. Association between complications and death within 30 days after noncardiac surgery. CMAJ. 2019;191(30):E830-E7. PubMed PMID: 31358597.

Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, et al. Pantoprazole to Prevent Gastroduodenal Events in Patients Receiving Rivaroxaban and/or Aspirin in a Randomized, Double-Blind, Placebo-Controlled Trial. Gastroenterology. 2019;157(2):403-12. PubMed PMID: 31054846.

Moayyedi P, Eikelboom JW, Bosch J, Connolly SJ, Dyal L, Shestakovska O, et al. Safety of Proton Pump Inhibitors Based on a Large, Multi-Year, Randomized Trial of Patients Receiving Rivaroxaban or Aspirin. Gastroenterology. 2019;157(3):682-91. PubMed PMID: 31152740.

Roshandel G, Khoshnia M, Poustchi H, Hemming K, Kamangar F, Gharavi A, et al. Effectiveness of polypill for primary and secondary prevention of cardiovascular diseases (PolyIran): a pragmatic, cluster-randomised trial. Lancet. 2019;394(10199):672-83. PubMed PMID: 31448738.

Coupland CAC, Hill T, Dening T, Morriss R, Moore M, Hippisley-Cox J. Anticholinergic Drug Exposure and the Risk of Dementia: A Nested Case-Control Study. JAMA Intern Med. 2019;179(8):1084-1093. PubMed PMID: 31233095.

Guide de pratique récents

Omega-3 Fatty Acids for the Management of Hypertriglyceridemia: A Science Advisory From the American Heart Association Référence

Kowdley KV, Brown KE, Ahn J, Sundaram V. ACG Clinical Guideline: Hereditary Hemochromatosis. Am J Gastroenterol. 2019;114(8):1202-18. PubMed PMID: 31335359.

Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society. Circulation. 2019;140(8):e333-e81. PubMed PMID: 30586771.

Référence du quiz clinique

Burch HB. Drug Effects on the Thyroid. N Engl J Med. 2019;381(8):749-61. PubMed PMID: 31433922.