Changes in symptoms, peak expiratory flow, and sputum flora during treatment with antibiotics of exacerbations in patients with chronic obstructive pulmonary disease in general practice.

Abstract

Background -Bacterial infections of the lower airways during an exacerbation in patients with asthma or chronic obstructive pulmonary disease (COPD) may be the cause of an exacerbation or the consequence of a viral infection or an increase in airways limitation. To determine whether bacterial infection is an important component in the pathogenesis of an exacerbation, the effects of antimicrobial treatment must be studied. Methods -Patients with asthma or COPD seen in general practice were studied in a double blind randomised manner to investigate whether the antimicrobial drugs amoxicillin (500 mg three times daily), cotrimoxazole (960 mg twice daily), or a placebo, each when added to a short course of oral corticosteroids, can accelerate recovery from exacerbations. Patients were instructed to contact their own physician early in the morning when complaints of increased shortness of breath, wheezing, or exacerbations of cough with or without sputum production occurred. (Thorax 1995;50:758-763)

Correlation of C-Reactive Protein and Copd Severity

“…The results of our study indicated that this type of relationship could only be applied to CRP level, but not to leukocyte count. These results are consistent with previously reported results [30][31][32] . Lower values of the mMRC dyspnea scale are associated with better spirometry and blood gas analysis results in COPD.…”

Guidelines for the management of adult lower respiratory tract infections

“…This conclusion and the fact that papers in these meta-analyses included both in-and outpatients, makes it uncertain as to whether antibiotic treatment in exacerbations in all primary care patients is useful. The two studies carried out in primary care failed to show relevant effects [30,31]. However, data on patients with severe exacerbations and exacerbations of mild and severe COPD in primary care were lacking.…”

Legionellaspp. in acute exacerbations of chronic obstructive pulmonary disease: what is the evidence?

“…At present, however, there is no such need. Firstly, the effect of antimicrobial treatment in acute exacerbations is probably confined to the subgroup of patients with ANTHONISEN et al [20] type-1 exacerbations and those with defined risk factors according to BALL et al [23] and other studies (cardiopulmonary comorbidity and frequent hospitalizations) [12,20,24,25]. Even then, the cure rate using placebo is high.…”