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A Breath of Fresh Air

Antibiotics for Patients Hospitalized With COPD Exacerbations

jfayyaz, DO, Pulmonary Medicine, 09:14PM Jun 1, 2010


Most of us treat patients with COPD exacerbations with antibiotics eventhough the etiology is more frequently viral. 

The COPD guidelines recommend antibiotics for patients with purulent sputum, or with an increase in sputum or dyspnea.  The evidence supporting these recommendations is based on small trials, many of which did not have hospitalized patients.

A study published in JAMA last week reports improved outcomes for COPD patients hospitalized for exacerbations.

The study was a retrospective cohort which consisted of almost 85,000 patients hospitalized for COPD exacerbations at over 400 centers throughout the US.  79% of the patients received antibiotics for at least two days.  The patients treated with antibiotics were less likely to require mechanical ventilation, had lower rates of inpatient mortality, and lower rates of readmission for COPD exacerbations.  In addition, treatment failure was lower in patients treated with antibiotics.
However the antibiotic treated group had higher rates of readmission for diarrhea and C. difficile.

It is difficult to determine whether a bacterial infection is the cause of exacerbations in these patients. 
The authors state that routine use of antibiotics may be appropriate for COPD exacerbations until additional studies are performed.     

About This Blog

This blog focuses on current clinical issues in pulmonary medicine, interesting cases, and recent journal articles. Comments and suggestions are always welcome.

The content of this blog does not necessarily reflect the viewpoints of Medscape.

Jazeela Fayyaz, DO, Chief Pulmonary Fellow, Lenox Hill Hospital, New York, NY
Jazeela Fayyaz, DO, has disclosed no relevant financial relationships.

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