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Discriminate use of antibiotics for exacerbation of COPD

Stolz, Daiana and Tamm, Michael. (2009) Discriminate use of antibiotics for exacerbation of COPD. Current opinion in pulmonary medicine, Vol. 15, H. 2. pp. 126-132.

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Official URL: http://edoc.unibas.ch/dok/A6007522

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Abstract

PURPOSE OF REVIEW: The relevance of antibiotics in the treatment of acute exacerbation has been a matter of debate for several years. Although expert recommendations may vary, there is general agreement about the fact that not all patients will equally experience benefit from antibiotics: apart from decreasing costs, discriminate use of antibiotics is capable of significantly reducing subsequent colonization or infection with antibiotic-resistant bacteria. RECENT FINDINGS: Several meta-analyses support the concept that patients with increased dyspnea, increased sputum volume, and increased sputum purulence will benefit from antimicrobial therapy. Evidence from randomized trials substantiates the prescription of antibiotics in patients receiving mechanical ventilation and the avoidance of antibiotics in those admitted with low serum procalcitonin levels. SUMMARY: Most of the proposed criteria for prescribing or withholding antibiotics for acute exacerbation have been analyzed in different retrospective study designs. Patients requiring ICU care and mechanical ventilation for chronic obstructive pulmonary disease exacerbation should receive antibiotics. Conversely, antibiotics can be withheld in patients admitted to the emergency department with low serum procalcitonin levels. Patients with type I Anthonisen exacerbation and those with severe functional impairment are likely to benefit from antibiotics. Further investigations are needed to compare long-term outcome in patients treated according to clinical and functional criteria.
Faculties and Departments:03 Faculty of Medicine > Departement Biomedizin > Department of Biomedicine, University Hospital Basel > Pulmonary Cell Research (Roth/Tamm)
03 Faculty of Medicine > Bereich Medizinische Fächer (Klinik) > Pneumologie > Pneumologie (Stolz)
03 Faculty of Medicine > Departement Klinische Forschung > Bereich Medizinische Fächer (Klinik) > Pneumologie > Pneumologie (Stolz)
UniBasel Contributors:Tamm, Michael and Stolz, Daiana
Item Type:Article, refereed
Article Subtype:Further Journal Contribution
Bibsysno:Link to catalogue
Publisher:Lippincott Williams & Wilkins
ISSN:1070-5287
Note:Publication type according to Uni Basel Research Database: Journal item
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Last Modified:18 Jul 2014 09:10
Deposited On:18 Jul 2014 09:10

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