Treatment cost of acute exacerbations of chronic bronchitis

Niederman, Michael S.; McCombs, Jeffrey S.; Unger, Alan N.; Kumar, Amit; Popovian, Robert

doi:10.1016/s0149-2918(00)88310-1

Cited by 129 publications

(67 citation statements)

References 10 publications

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“…It may also lead to more hospitalization and prolonged absence from work. This greatly increases the cost of AECB treatment (292,293). Stratification of patients into risk categories may allow the physician to select targeted antimicrobial therapy to prevent some of these consequences.…”

Section: Risk Stratificationmentioning

confidence: 99%

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Balter

Forge

Low

et al. 2003

Canadian Respiratory Journal

116

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Acute exacerbations of chronic bronchitis (AECB) account for over 1.5 million physician visits annually in Canada and are a cause of significant morbidity and mortality. This document represents a joint effort between respirologists, microbiologists, infectious disease specialists and family physicians to update the Canadian AECB guidelines published in 1994. Treatment recommendations are graded on the strength of evidence in the published literature where possible. The role for oral corticosteroid therapy in preventing treatment failures, speeding up recovery and delaying the time to next exacerbation is discussed. Risk factors for treatment failure were used to stratify patients into risk groups to help guide antibiotic treatment recommendations. The importance of emerging antimicrobial resistance to current antibiotics is reviewed and strategies to prevent future AECB episodes are suggested.

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Section: Risk Stratificationmentioning

confidence: 99%

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Balter

Forge

Low

et al. 2003

Canadian Respiratory Journal

116

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“…2 Although the vast majority of American patients who experience AECB seek care on an out-patient basis, many require hospitalization, thus driving up the direct cost of treatment to an estimated US$1.6 billion annually. 3 One of the difficulties associated with the treatment of AECB is identifying the cause of each exacerbation, which might be an infection, an environmental pollutant or an allergic response. 2 The importance of antibacterial therapy in AECB is a contentious topic, with most evidence emerging in favour of such therapy.…”

Section: Introductionmentioning

confidence: 99%

Oral Telithromycin 800 mg Once Daily for 5 Days versus Cefuroxime Axetil 500 mg Twice Daily for 10 Days in Adults with Acute Exacerbations of Chronic Bronchitis

Zervos

Heyder

Leroy³

2003

J Int Med Res

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The efficacy and safety of a 5-day regimen of 800 mg telithromycin once daily was compared with a standard 10-day regimen of 500 mg cefuroxime axetil twice daily in a multicentre, randomized, double-blind, parallel-group trial involving 376 patients with acute exacerbations of chronic bronchitis (AECB). In clinically evaluable patients (n = 282), post-therapy clinical cure rates were 86.4% with telithromycin and 83.1% with cefuroxime axetil. In bacteriologically evaluable patients (n = 53), eradication or presumed eradication of the pathogen was achieved in 76.0% and 78.6% of telithromycin and cefuroxime axetil patients, respectively. Adverse events were mostly mild; the most common were diarrhoea (12.8% versus 11.8%) and nausea (8.9% versus 3.2%) in telithromycin and cefuroxime axetil patients, respectively. The 5-day regimen of 800 mg telithromycin once daily was similar in efficacy and equally well tolerated as a 10-day regimen of 500 mg cefuroxime axetil twice daily in adults with AECB.

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“…Exacerbations have a considerable effect on morbidity and quality of life of COPD patients [19], and constitute an important cause of hospital admission and re-admission, with the consequent high burden on the healthcare system [19,20]. In 1995, in the USA, total direct costs of inpatient and physician services for the treatment of acute exacerbations of COPD accounted for y1.6 billion dollars [21] and in 1998, 662,000 hospitalisations (1.9% of all hospitalisations) were attributed to COPD [22].…”

mentioning

confidence: 99%

Inhaled corticosteroids and the risk of a first exacerbation in COPD patients

Melo¹,

Ernst²,

Suissa³

2004

Eur Respir J

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Inhaled corticosteroids and the risk of a first exacerbation in COPD patients. M.N. de Melo, P. Ernst, S. Suissa. #ERS Journals Ltd 2004. ABSTRACT: The role of inhaled corticosteroids (ICS) in asthma is well established, but their benefit in the management of chronic obstructive pulmonary disease (COPD) is still controversial. The current study assessed whether ICS are effective in preventing a first exacerbation of COPD.A cohort of newly treated COPD patients was formed from the Administrative Databases of Saskatchewan Health. The outcome was the occurrence of a first moderate or severe exacerbation from 1990-1999. Moderate exacerbations involved prescriptions for an antibiotic and an oral corticosteroid on the same day. Severe exacerbations were hospitalisations with a primary discharge diagnosis of COPD. A nested case-control design was used and matched on year of birth and cohort entry. Rate ratios (RR) were further adjusted for use of other medication and other confounders.There were 995 exacerbations among 4,455 subjects. The rate of a first exacerbation was increased with any use of ICS in the year prior to the index date (RR: 1.27; 95% CI: 1.08-1.48) and with current use (RR: 1.51; 95% CI: 1.22-1.87), and it increased with increasing daily doses of ICS.Inhaled corticosteroids do not seem to be beneficial in reducing the risk of a first exacerbation of chronic obstructive pulmonary disease.

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Treatment cost of acute exacerbations of chronic bronchitis

Cited by 129 publications

References 10 publications

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Oral Telithromycin 800 mg Once Daily for 5 Days versus Cefuroxime Axetil 500 mg Twice Daily for 10 Days in Adults with Acute Exacerbations of Chronic Bronchitis

Inhaled corticosteroids and the risk of a first exacerbation in COPD patients

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