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Patients who are treated for acute exacerbations of chronic obstructive pulmonary disease (COPD) often fail to return to baseline; some suffer repeat exacerbations, and others are left with prolonged residual symptoms. Clinicians habitually treat these patients with additional empiric antibiotic courses, although no evidence supports this practice.
In a double-blinded study, researchers in the U.K. identified 144 patients with COPD who were not fully recovered from an acute exacerbation despite a course of a nonquinolone antibiotic with or without steroids. All were either persistently symptomatic 2 weeks later or had markedly elevated C-reactive protein (CRP) levels (mean, 15.3 µg/mL), or both. Patients were randomized to receive 1 week of …