Chronic obstructive pulmonary disease: rational antibiotic therapy

Chronic obstructive pulmonary disease (COPD) − the most common pathology that can be prevented.

According to World Health Organization, this disease is now the fourth leading cause of death in the world and, according to experts, will take the third place by 2020.

According to various estimates, at least 4% of the population is diagnosed with chronic obstructive pulmonary disease, and about 2% of deaths are due to this disease.

Read the article on estet-portal.com how effective antibiotic therapy is at the initial stage of medical care care for chronic obstructive pulmonary disease.

• Clinical presentation and causes of chronic obstructive pulmonary disease
• Methods and results of a study regarding the prescription of antibiotics in patients with COPD
• Conclusions from the study of antibiotic therapy in COBL

Clinical picture and causes of chronic obstructive pulmonary disease

COPD − general name for a group of diseases characterized by persistent respiratory symptoms and airway obstruction due to pathological changes in the airways and/or damage to the alveoli, usually caused by a significant negative impact of harmful particles or gas.

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The disease significantly restricts the normal life of the patient, which is caused by cough, persistent shortness of breath, progressive sputum production.

Long-term smoking and the formation of chronic bronchitis as a result of this is the leading cause of the development of chronic obstructive pulmonary disease.

Scientists from University College London, UK (University College London, UCL), conducted a study on rational antibiotic prescribing in exacerbation of COBL.

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Methods and results of the study regarding the prescription of antibiotics in patients with COPD

Using the Primary Care Database, University College London analyzed data from 19,594 patients with chronic obstructive pulmonary disease (mean age − 71 years; 46% women) who were followed up in during the year.

Approximately 70-80% had mild to moderate disease (GOLD 1-2 or MRC 1-3). This cohort of patients represents 2.6% of all patients in the general population.

The results indicate that 833 (4.5%) patients with severe chronic obstructive pulmonary disease and frequent exacerbations received antibiotics six to nine times a year.

And patients with mild to moderate COPD who have no more than one exacerbation per year were prescribed antibiotics one to three times a year, accounting for 42.5% of all antibiotic prescriptions.

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In adjusted analyses, factors associated with frequent antibiotic prescribing were:

• age (> 60 years old);
• female;
• comorbidities, including asthma, coronary heart disease, diabetes mellitus, and heart failure;
• Available influenza vaccination.

Meanwhile, patients who continued to smoke received an average of 9% less antibiotics.

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Study co-author Dr. Lara Shallcross (Lara Shallcross) commented the results as follows:

"Quantification of the costs and benefits of unnecessary antibiotic prescribing in patients with chronic obstructive pulmonary disease may help clinicians make informed decisions about antibiotic prescribing.

I would not conclude that it is wrong to prescribe antibiotics for the treatment of patients with exacerbations of COPD, but today the recommendations support their use in people with increasing dyspnea, increased sputum volume, and change in its nature a».

Conclusions from the study of antibiotic therapy in COPD

Study shows that physicians overprescribe antibiotics for COPD, especially in mild to moderate cases. 

It should be remembered that treatment with antibiotics brings both risks and benefits to patients.

It is particularly difficult to balance the risks in primary care where, on the one hand, doctors have limited information about the specifics of the disease, and, on the other hand, delay in prescribing antibiotics can exacerbate chronic lung diseases.

Specialists recommend against routine antibiotics for people at low risk of exacerbating COPD.

Despite the fact that COPD is a progressive disease, the researchers note that correctly selected and treatmenton time can significantly slow the progression, prevent complications and improve the quality of life of patients.