Should All Patients with COPD Exacerbations Be Treated with Antibiotics?

In those with mild-to-moderate chronic obstructive pulmonary disease, only purulent sputum and high C-reactive protein levels predicted need for antibiotics.

Patients with severe chronic obstructive pulmonary disease (COPD) exacerbations are treated with antibiotics, but do patients with less-severe disease also need them? In a 2012 trial of outpatients with mild-to-moderate COPD exacerbations (forced expiratory volume in 1 second, >50% of predicted) who received either amoxicillin/clavulanate or placebo, 80% of 152 placebo patients had satisfactory outcomes in the absence of antibiotic therapy (Am J Respir Crit Care Med 2012; 186:716).

To predict which patients would do well without antibiotics, investigators examined the data from the placebo group of this trial. COPD exacerbations were defined by the classical symptoms of increased dyspnea, increased volume of sputum, and increased purulence o…

Reviewing Author

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Patricia Kritek, MD

Disclosures

Editorial BoardsATS Scholar

Should All Patients with COPD Exacerbations Be Treated with Antibiotics?

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Reviewing Author