Two-Day Course of Antibiotics for COPD Exacerbation?

Guidelines recommend 5 to 7 days of antimicrobial therapy for patients with chronic obstructive pulmonary disease (COPD) exacerbations who exhibit all three cardinal symptoms (i.e., increased dyspnea, increased sputum volume, increased sputum purulence) or increased purulence plus one other symptom (Global Initiative for Chronic Obstructive Lung Disease guidelines). Shorter antimicrobial regimens rarely have been studied. Tunisian investigators randomized 310 adults who presented to an emergency department (ED) with acute exacerbations of COPD and at least two cardinal symptoms to receive either 2 or 7 days of levofloxacin (500 mg daily dose). Patients thought to have pneumonia were excluded. All enrolled patients received other standard th…