Article Text

other Versions

PDF

Short course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies
  1. Rachida El Moussaoui (r.elmoussaoui{at}amc.uva.nl)
  1. Academical Medical Center, Netherlands
    1. Berendina M Roede (i.roede{at}amc.uva.nl)
    1. Academic Medical Center - University of Amsterdam, Netherlands
      1. Peter Speelman (p.speelman{at}amc.uva.nl)
      1. Academic Medical Center - University of Amsterdam, Netherlands
        1. Paul Bresser (p.bresser{at}amc.uva.nl)
        1. Academic Medical Center - University of Amsterdam, Netherlands
          1. Jan M Prins (j.m.prins{at}amc.uva.nl)
          1. Academic Medical Center - University of Amsterdam, Netherlands
            1. Patrick M Bossuyt (p.m.bossuyt{at}amc.uva.nl)
            1. Academic Medical Center - University of Amsterdam, Netherlands

              Abstract

              Objective: To determine whether a short course of antibiotic treatment (up to 5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and COPD.

              Methods: MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Eligible were double-blind randomized clinical trials including adult patients ≥ 18 years of age with clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment up to 5 days versus longer than 5 days. Primary outcome measure was clinical cure at early follow-up, on intention to treat basis.

              Results: 21 studies with a total of 10698 patients were included. The average quality of the studies was high: the mean Jadad score was 3.9 (SD 0.9). At early follow-up (<25 days) the summary odds ratio (OR) for clinical cure with short treatment versus conventional treatment was 0.99 (95% CI 0.90 to 1.08). At late follow-up the summary OR was 1.0 (95% CI 0.91 to 1.10) and the summary OR for bacteriological cure was 1.05 (95% CI 0.87 to 1.26). Similar summary ORs were observed for early cure in trials with the same antibiotic in both arms and in studies grouped by the antibiotic class used in the short-course arm.

              Conclusions: A short course of antibiotic treatment is as effective as the traditional longer treatment in patients with mild to moderate exacerbations of chronic bronchitis and COPD.

              • COPD
              • antibiotics
              • meta-analysis
              • short-course

              Statistics from Altmetric.com

              Request permissions

              If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

              Linked Articles