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Although some studies have shown that antibiotics reduce symptoms in patients with acute exacerbations of chronic obstructive pulmonary disease, their role as add-on therapy in patients who are treated with systemic steroids has not been investigated. In a trial from the Netherlands, 265 patients who were hospitalized for COPD exacerbations received methylprednisolone (starting with 60 mg daily and then tapered); additionally, they were randomized to receive either daily oral doxycycline (200 mg) or placebo for 7 days. Patients with fever or radiographic infiltrates were excluded.
The incidence of the primary outcome — complete or partial resolution of signs and symptoms at 30 days — was not significantly different in the two groups. However…