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.
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.