RT Journal Article
SR Electronic
T1 Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 415
OP 422
DO 10.1136/thx.2007.090613
VO 63
IS 5
A1 R El Moussaoui
A1 B M Roede
A1 P Speelman
A1 P Bresser
A1 J M Prins
A1 P M M Bossuyt
YR 2008
UL http://thorax.bmj.com/content/63/5/415.abstract
AB Background: A study was undertaken to determine whether a short course of antibiotic treatment (⩽5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD).Methods: MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Studies considered eligible were double-blind randomised clinical trials including adult patients ⩾18 years of age with a clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment for ⩽5 days versus >5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis.Results: 21 studies with a total of 10 698 patients were included. The average quality of the studies was high: the mean (SD) Jadad score was 3.9 (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.