Antibacterial therapy of cOpd exacerbations: prescribe or not prescribe


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The article discusses the strategy and tactics of antibacterial therapy in patients with acute exacerbation of COPD. The presence of infectious and non-infectious exacerbations requires an individualized approach to the addressing the issue of the appointment of antibacterial drug (AD). The majority of cases of infectious exacerbations are caused by bacterial pathogens, less frequently - by viruses. Selection of AD is based on antimicrobial activity against key bacterial causative agents, minimal risk of antibiotic resistance, optimal pharmacokinetics, and safety. AD efficiency is established in placebo-controlled studies in patients with severe infectious exacerbations of COPD. In assessing the effectiveness of AD in patients with exacerbations of COPD, the main criterion is the duration of recurrence-free period, which is determined by the eradication ability of AD.

Full Text

Restricted Access

About the authors

Leonid I. Dvoretsky

I.M. Sechenov First Moscow state medical University

Email: dvoretski@mail.ru
MD, professor, head of the Department of hospital therapy №2

Yelena V. Sergeeva

I.M. Sechenov First Moscow state medical University

Ph, associate professor of the Department of hospital therapy №2

References

  1. Hirschmann J.V. Do acute exacerbations of chronic bronchitis need to be treated with antibiotics No. Current treatment options in infections diseases. 2002;4:381.
  2. Boersma G.W. Antibiotics in acute exacerbatios of COPD: the good, the bad and the ugly. Eur. Resp. J. 2012;40:1-3.
  3. Nissly T., Prasad S., Stevermer J., Stevermer James. PURLs: Should you consider antibiotics for exacerbations of mild COPD? J. Fam Pract. 2014;63(4):E11-E13.
  4. Saint S., Bent S., Vittinghof E., Grady D. Antibiotics in chronic obstructive pulmonary disease exacerbations. A metaanalisis. JAMA. 1995;273;957-60.
  5. Ram F.S., Rodriguez-Roisin R., Granados-Navarrete A., Barnes N.C. Antibiotics for exacerbations of chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006;(2):CD004403.
  6. Puhan M., Vollenweider D., Latshang T. et al. Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review. Respir. Res. 2007;8:30.
  7. Daniels J.M., Snijders D., de Graaff C.S., Vlaspolder F., Jansen H.M., Boersma W.G. Antibiotics in addition to systemic corticosteroids for acute exacerbations of chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2010;181(2):150-7.
  8. Cosio B.G., Garcia-Nunez M., Monso E. et al. Microbiology of COPD exacerbations at hospital admission: the ECOS study. Eur. Resp. J. 2010;36 (Suppl. 54):684s.
  9. Mallia P., Message S., Contoli M. et al. Rhinovirus infection induces increases in CD3+ and CD8+ T cells in BAL in COPD patients. Eur. Respir. J. 2010;36 (Suppl. 54):686s.
  10. Perotin J.M, Andreoletti L., Deslee G. et al. RT-PCR microarray detection of viral respiratory pathogens demonstrateds the major role of human metapneumovirus and human rhinovirus in acute exacerbations of COPD in France. Eur. Respir. J. 2010;36 (Suppl. 54):686s.
  11. Seth S., File T. M. Managing patients with recurrent acute exacerbations of chronic bronchitis: a common clinical problem. Curr. Med. Res. Opin. 2004;20(10):1511-21.
  12. Anthonisen N.R., Manfreda J., Warren C.P., Hershfield E.S., Harding G.K., Nelson N.A. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann. Intern. Med. 1987;106:196-204.
  13. Stockley R.A., O'Brien C., Pye A., Hill S.L. Relationship of sputum color to nature and outpatient management of acute exacerbations of COPD. Chest. 2000;117(6):1638-45.
  14. Johnson A.L., Hampson D.F., Hampson N.B. Sputum color: potential implications for clinical practice. Respir. Care. 2008;53(4):450-4.
  15. Daniels J.M., de Graaff C.S., Vlaspolder F., Snijders D., Jansen H.M., Boersma W.G. Sputum color reported by patients is not a reliable marker of the presence of bacteria in acute exacerbations of chronic obstructive pulmonary disease. Clin. Microbiol. Infect. 2010;16(6):583-8.
  16. Lacoma A., Prat C., Andreo F., Lores L., Ruiz-Manzano J., Ausina V., Dominguez J. Value of procalcitonin, C-reactive protein, and neopterin in exacerbations of chronic obstructive pulmonary disease. Int. J. Chron. Obstruct. Pulmon. Dis. 2011;6:157-69.
  17. Tanriverdi H., Örnek T., Erboy F., Altinsoy B., Uygur F., Atalay F., Tor M. Comparison of diagnostic values of procalcitonin, C-reactive protein and blood neutrophil/lymphocyte ratio levels in predicting bacterial infection in hospitalized patients with acute exacerbations of COPD. Wien Klin. Wochenschr. 2015;127(19-20):756-63.
  18. Chang C.H., Tsao K.C., Hu H.C., Huang C.C., Kao K.C., Chen N.H., Yang C.T., Tsai Y.H., Hsieh M.J. Procalcitonin and C-reactive protein cannot differentiate bacterial or viral infection in COP D exacerbation requiring emergency department visits. Int. J. Chron. Obstruct. Pulmon. Dis. 2015;10:767-74.
  19. Jacobs M.R. How can we predict bacterial eradication? Intern. J. Inf. Dis. 2003;7 (Suppl. 1):S13-20.
  20. Pettigrew M.M., Tsuji B.T., Gent J.F., Kong Y., Holden P.N., Sethi S., Murphy T.F. Effect of fluoroquinolones and macrolides on eradication and resistance of Haemophilus influenzae in chronic obstructive pulmonary disease. Antimicrob. Agents Chemother. 2016;60(7):4151-8.
  21. Волков И.К., Катосова Л.К., Щербакова Т.Ш., Клюкина Д.З. Morazella catarrhalis при хронических и рецидивирующих инфекциях дыхательных путей у детей. Антибиотики и химиотерапия. 2012;49:43-7. [Volkov I.K., Katosova L.K., Scherbakova T.Sh., Klyukina D.Z. Morazella catarrhalis in chronic and relapsing respiratory tract infections in children. Antibiotics and chemotherapy. 2012;49:43-7 (in Russ.)]
  22. Стратегия и тактика рационального применения антимикробных средств в амбулаторной практике. Евразийские клинические рекомендации. Москва, 2016. [Strategy and tactics for the rational use of antimicrobial agents in ambulatory practice. Eurasian clinical guidelines. Moscow, 2016 (in Russ.)]
  23. Biedenbach D.J., Badal R.E., Huang M.Y., Motyl M., Singhal P.K., Kozlov R.S., Roman A.D., Marcella S. In vitro activity of oral antimicrobial agents against pathogens associated with community-acquired upper respiratory tract and urinary tract infections: a five country surveillance study. Infect. Dis. Ther. 2016;5(2):139-53.
  24. Chodosh S. Clinical significance of the infection-free interval in the management of acute bacterial exacerbations of chronic bronchitis. Chest. 2005;127:2231-6.
  25. Llor C., Moragas A., Hernandez S., Bayona C., Miravitlles M. Efficacy of antibiotic therapy for acute exacerbations of mild to moderate chronic obstructive pulmonary disease. Am. J. Respir. Crit. Care Med. 2012;186(8):716-23.
  26. Miravitlles M., Hernandez S. Is it possible to identify exacerbations of mild to moderate COPD that do not require antibiotic treatment? CHEST 2013;144(5):1571-7.
  27. Lorenz J., Steinfeld P., Drath L., HYPERLINK «https://www.ncbi.nlm.nih.gov/pubmed/?term=Keienburg%20T%5 BAuthor%5D&cauthor=true&cauthor_uid=18370461 » Keienburg T., HYPERLINK «https://www.ncbi.nlm.nih.gov/ pubmed/?term=Troester%20K%5BAuthor%5D&cauthor=true&cauthor_uid=18370461 » Troester K. Efficacy and tolerability of 5- vs 10-day cefixime therapy in acute exacerbation of chronic bronchitis. Clin. Drug. Invest. 1998;15:13-20.
  28. Arthur M., McAdoo M., Guerra J., HYPERLINK «https://www.ncbi.nlm.nih.gov/pubmed/?term = Maloney%20R%5 BAuthor%5D&cauthor=true&cauthor_uid = 1 1862302» Maloney R., HYPERLINK «https://www.ncbi.nlm.nih.gov/ pubmed/?term=McCluskey%20D%5BAuthor%5D&cauthor=true&cauthor_uid=11862302» McCluskey D., HYPERLINK «https://www.ncbi.nlm.nih.gov/pubmed/?term=Giguere%20G%5BAuthor%5D&cauthor=true&cauthor_uid=1 1862302» g1 Gigue re G., HYPERLINK «https ://www.ncbi.nlm.nih.gov/pubmed/?term=Gomez%20G%5BAuthor%5D&cauthor=true&c author_uid=1 1862302» Gomez G., HYPERLINK «https://www.ncbi.nlm.nih.gov/pubmed/?term=Collins%20JJ%5BAuthor %5D&cauthor=true&cauthor_uid=11862302» Collins J.J. Clinical comparison of cefuroxime axetil with cefixime in the treatment of acute bronchitis. Am. J. Ther. 1996;3:622-9.
  29. Lieberman D., Schlaeffer F. Once-a-day cefixime versus co-amoxiclav three times daily in the treatment of lower respiratory infections. J. Antimicrob. Chemother. 1995;35:354-7.
  30. Цой А.Н., Гучев И.А., Сафонова Е.В. Цефиксим. Клиническая эффективность при обострении нетяжелой ХОБЛ и влияние на развитие рецидивов заболевания. Лечащий врач. 2011;1:86-90. [Tsoi A.N., Guchev I.A., Safonova Ye.V. Cefixime. Clinical efficacy in exacerbations of mild COPD and the influence on development of relapses. Lechashchiy vrach. 2011;1:86-90 (in Russ.)]

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2017 Bionika Media

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies