Antibiotics for Acute Exacerbations in COPD: Comparability of Effectiveness and Tolerability


A current meta-analysis revealed in BMC Pulmonary Medication discovered that dirithromycin had a excessive medical remedy charge with a low opposed impact charge in sufferers with acute exacerbations from power obstructive pulmonary illness (COPD); ofloxacin, ciprofloxacin, and trimethoprim-sulfamethoxazole additionally had excessive medical remedy charges, however median charges of opposed results.

The authors searched the PubMed, EmBase, and Cochrane databases for randomized managed trials revealed as much as September 2016 that evaluated the usage of antibiotics for the remedy of acute exacerbations of COPD.

Main examine finish factors had been medical remedy charges and opposed results; microbiological response charge, relapse of exacerbation, and mortality had been analyzed as properly. The researchers used a random-effect community to evaluate the effectiveness and tolerability of every antibiotic utilized in acute exacerbations of COPD.

Proceed Studying

The authors included 19 articles assessing 17 antibiotics utilized in 5906 sufferers with acute exacerbations of COPD. Cluster rating demonstrated that dirithromycin had excessive medical remedy charges with a low charge of opposed results. Rating the therapies primarily based on floor beneath the cumulative rating likelihood scores, the authors famous that when it comes to efficacy, ofloxacin (79.1%) was the almost definitely to be the perfect antibiotic for treating acute exacerbations of COPD, adopted by ciprofloxacin (70.4%) and trimethoprim-sulfamethoxazole (68.1%). When it comes to tolerability, dirithromycin (88.4%) was almost definitely to be the perfect drug, adopted by azithromycin (81.4%) and amoxicillin (68.6%).

The authors carried out conventional meta-analysis for microbiological response charge, frequency of recurrence, and mortality. Solely the microbiological response charge of doxycycline was considerably higher than placebo (odds ratio, 3.84; 95% CI, 1.96-7.54; P <.001). No vital outcomes had been discovered for frequency of recurrence or mortality charges.

The authors concluded that this community meta-analysis supplied a extra complete understanding of the efficacy and tolerability of the antibiotics and allowed for oblique comparability of the medicine. Nonetheless, they suggested warning in utilizing antibiotics to deal with exacerbations of COPD, as opposed results happen with all of those medicine.


Zhang H-L, Tan M, Qiu A-M, Tao Z, Wang C-H. Antibiotics for remedy of acute exacerbation of power obstructive pulmonary illness: a community meta-analysis. BMC Pulm Med. 2017;17(1):196.


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