Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD

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A study was undertaken to determine whether a short course of antibiotic treatment ( 5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD).
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<p>MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Studies considered eligible were double-blind randomised clinical trials including adult patients &gt;18 years of age with a clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment for &lt;5 days versus &gt;5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis. </p>
<p>21 studies with a total of 10698 patients were included. The average quality of the studies was high: the mean (SD) Jadad score was 3.9 (0.9). At early follow-up (&lt;25 days), the summary odds ratio (OR) for clinical cure with short treatment versus conventional treatment was 0.99 (95% CI 0.90 to 1.08). At late follow-up the summary OR was 1.0 (95% CI 0.91 to 1.10) </p>
<p>Similar summary ORs were observed for early cure in trials with the same antibiotic in both arms and in studies grouped by the antibiotic class used in the short-course arm. </p>
<p>A short course of antibiotic treatment is as effective as the traditional longer treatment in patients with mild to moderate exacerbations of chronic bronchitis and COPD. </p>
<p><strong>Source: Thorax 2008;63:415-422</strong></p>