Impact of antibiotics on acute exacerbations of COPD

BackgroundMost patients with an exacerbation of chronic obstructive pulmonary disease (COPD) are treated with antibiotics. However the value of their use remains uncertain. Some controlled trials of antibiotics have shown benefit while others have not. This study was conducted in order to help resolve the issues surrounding the value of antibiotic therapy for exacerbations of COPD.Patients and methodsOne hundred subjects were recruited from patients with type 1 exacerbation of COPD referred to the outpatient clinics of Assiut and Al-Azhar University hospitals for treatment of COPD exacerbation from April 2013 to October 2014. Patients were divided into two groups, placebo and antibiotic group. Each group contain 50 patients, the placebo group received (bronchodilators, corticosteroids), the treatment group received bronchodilators, corticosteroids, and 10 day course of antibiotics.ResultsThe frequency of individual symptoms was significantly different before and after treatment in antibiotic and placebo-treated groups. Lung function studies showed no significant difference in both antibiotic-treated and placebo groups. Peak flow data increased in antibiotic treated group and in placebo treated group without statistical significance (p = 0.205, paired t-test). However, this increase in PEFR occurs significantly more rapid and in shorter duration in antibiotic-treated group than placebo group (15 ± 3 days versus 18 ± 5 days) p = 0.001. The success rate was higher in antibiotic-treated exacerbations while failure with deterioration was higher in placebo-treated group. When exacerbations without deterioration were considered, antibiotic-treated exacerbations showed more rapid improvement in symptoms than those with placebo treated group (13 ± 7 days versus 16 ± 6 days) p = 0.02.ConclusionsIn conclusion, this study has clearly shown that in type 1 exacerbations of COPD, antibiotic therapy, significantly results in decrease in duration of treatment, success rate and more rapid improvement in peak flow.