Featured Research

from universities, journals, and other organizations

Early antibiotic treatment for severe COPD symptoms linked with improved outcomes

Date:
May 26, 2010
Source:
JAMA and Archives Journals
Summary:
Among patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD), those who received antibiotics in the first 2 hospital days had improved outcomes, such as a lower likelihood of mechanical ventilation and fewer re-admissions, compared to patients who received antibiotics later or not at all, according to a new study.

Among patients hospitalized for acute exacerbations of chronic obstructive pulmonary disease (COPD), those who received antibiotics in the first 2 hospital days had improved outcomes, such as a lower likelihood of mechanical ventilation and fewer readmissions, compared to patients who received antibiotics later or not at all, according to a study in the May 26 issue of JAMA.

Related Articles


The fourth lead­ing cause of death in the United States is COPD, which affects at least 12 million U.S. resi­dents. "Acute exacerbations of COPD are re­sponsible for more than 600,000 hos­pitalizations annually, resulting in di­rect costs of more than $20 billion," the authors write. "Guidelines recommend antibiotic therapy for acute exacerbations of COPD, but the evidence is based on small, heterogeneous trials, few of which include hospitalized patients."

Michael B. Rothberg, M.D., M.P.H., of Baystate Medical Center, Springfield, Mass., and colleagues examined the association between use of antibiotics and outcomes among patients (40 years of age or older) hospi­talized for acute exacerbations of COPD at 413 acute care facilities throughout the United States, between January 2006 and December 2007. The primary outcomes analyzed included a composite measure of treatment failure, defined as the initiation of mechanical ventilation after the second hospital day, inpatient mortality, or readmission for acute exacerbations of COPD within 30 days of discharge; length of stay, and hospital costs.

Of 84,621 patients, 79 percent received at least 2 consecutive days of antibiotic treatment. The researchers found that compared with patients not receiv­ing antibiotics in the first 2 days, anti­biotic-treated patients were less likely to receive mechanical ventilation af­ter the second hospital day (1.07 percent vs. 1.80 percent), had lower inpatient mortality (1.04 percent vs. 1.59 percent), a lower incidence of treatment failure (9.77 percent vs. 11.75 percent), and lower rates of readmission for acute exacerbations of COPD (7.91 percent vs. 8.79 percent). Pa­tients treated with and without antibi­otics had similar lengths of stay, but patients treated with antibiotics had lower costs.

Patients treated with antibiotic agents had a higher rate of readmissions for the bacterial infection Clostridium difficile than those who were not treated. After further analysis, the risk of treatment failure was lower in antibiotic-treated patients. "Analy­sis stratified by risk of treatment failure found similar magnitudes of benefit across all subgroups," the authors write.

The researchers add that two findings, that all patient groups seemed to benefit from therapy and that harms were minimal, support the notion that all patients hospitalized with acute exacerbations of COPD should be prescribed antibiotics. "This recommendation, however, is not consistent with the fact that roughly 50 percent of COPD patients do not have a bacterial etiology for their exacerbation. Identifying these patients remains a challenge, because sputum cultures do not distinguish between active infection and colonization. New bacterial infections may cause exacerbations and are associated with increases in inflammatory markers, … whereas colonization is not."

"… until more data are available, routine use of antibiotics for acute exacerbations of COPD may be appropriate," the authors conclude.


Story Source:

The above story is based on materials provided by JAMA and Archives Journals. Note: Materials may be edited for content and length.


Journal Reference:

  1. Michael B. Rothberg; Penelope S. Pekow; Maureen Lahti; Oren Brody; Daniel J. Skiest; Peter K. Lindenauer. Antibiotic Therapy and Treatment Failure in Patients Hospitalized for Acute Exacerbations of Chronic Obstructive Pulmonary Disease. JAMA, 2010; 303 (20): 2035-2042 [link]

Cite This Page:

JAMA and Archives Journals. "Early antibiotic treatment for severe COPD symptoms linked with improved outcomes." ScienceDaily. ScienceDaily, 26 May 2010. <www.sciencedaily.com/releases/2010/05/100525171323.htm>.
JAMA and Archives Journals. (2010, May 26). Early antibiotic treatment for severe COPD symptoms linked with improved outcomes. ScienceDaily. Retrieved November 25, 2014 from www.sciencedaily.com/releases/2010/05/100525171323.htm
JAMA and Archives Journals. "Early antibiotic treatment for severe COPD symptoms linked with improved outcomes." ScienceDaily. www.sciencedaily.com/releases/2010/05/100525171323.htm (accessed November 25, 2014).

Share This


More From ScienceDaily



More Health & Medicine News

Tuesday, November 25, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

From Popcorn To Vending Snacks: FDA Ups Calorie Count Rules

Newsy (Nov. 25, 2014) — The US FDA is announcing new calorie rules on Tuesday that will require everywhere from theaters to vending machines to include calorie counts. Video provided by Newsy
Powered by NewsLook.com
Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Daily Serving Of Yogurt Could Reduce Risk Of Type 2 Diabetes

Newsy (Nov. 25, 2014) — Need another reason to eat yogurt every day? Researchers now say it could reduce a person's risk of developing type 2 diabetes. Video provided by Newsy
Powered by NewsLook.com
Madagascar Working to Contain Plague Outbreak

Madagascar Working to Contain Plague Outbreak

AFP (Nov. 24, 2014) — Madagascar said Monday it is trying to contain an outbreak of plague -- similar to the Black Death that swept Medieval Europe -- that has killed 40 people and is spreading to the capital Antananarivo. Duration: 00:42 Video provided by AFP
Powered by NewsLook.com
Are Female Bosses More Likely To Be Depressed?

Are Female Bosses More Likely To Be Depressed?

Newsy (Nov. 24, 2014) — A new study links greater authority with increased depressive symptoms among women in the workplace. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins