Value of ampicillin in the hospital treatment of exacerbations of chronic bronchitis.

Elmes, P. C.; King, Tori; Langlands, Jean H. M.; Mackay, J; Wallace, W. F. M.; Wade, O. L.; Wilson, Thomas S.

doi:10.1136/bmj.2.5467.904

Cited by 89 publications

(23 citation statements)

References 6 publications

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“…Eleven years ago, a meta-analysis suggested a small improvement of lung function by antibiotics in COPD patients with an exacerbation, but the review was limited by the restriction to articles in English and its focus on lung function [11]. A recent systematic review [12] considered patient-important outcomes but missed some studies and included a non-randomised trial[13]. Inclusion of all available trials is, however, crucial to avoid selection bias and to study factors modifying the effects of antibiotics such as severity of exacerbation.…”

Section: Introductionmentioning

confidence: 99%

Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review

et al. 2007

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Section: Introductionmentioning

confidence: 99%

Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review

et al. 2007

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“…Randomized, placebocontrolled antimicrobial trials conducted in previous decades were inconclusive (202)(203)(204)(205)(206)(207) (Table 3). Many of the earlier studies were not powered to reach a definitive conclusion, but more recent well-designed studies have concluded that antibiotics are effective.…”

Section: Antibiotic Therapymentioning

confidence: 99%

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Balter

Forge

Low

et al. 2003

Canadian Respiratory Journal

116

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Acute exacerbations of chronic bronchitis (AECB) account for over 1.5 million physician visits annually in Canada and are a cause of significant morbidity and mortality. This document represents a joint effort between respirologists, microbiologists, infectious disease specialists and family physicians to update the Canadian AECB guidelines published in 1994. Treatment recommendations are graded on the strength of evidence in the published literature where possible. The role for oral corticosteroid therapy in preventing treatment failures, speeding up recovery and delaying the time to next exacerbation is discussed. Risk factors for treatment failure were used to stratify patients into risk groups to help guide antibiotic treatment recommendations. The importance of emerging antimicrobial resistance to current antibiotics is reviewed and strategies to prevent future AECB episodes are suggested.

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“…This controversy is fuelled by data suggesting that at least one-third of exacerbations are non-infectious in origin 3 – 5. In addition, clinical trials of antibiotics have yielded conflicting data, with several large studies failing to demonstrate superiority of antibiotic therapy over placebo 6 7. Other trials indicated that antibiotic therapy is effective in patients who have at least two of the following symptoms: increased dyspnoea, increased sputum volume and increased sputum purulence (ie, a type 1 or 2 exacerbation),8 and in those with more severe airflow obstruction 9.…”

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confidence: 99%

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Moussaoui¹,

Roede

Speelman³

et al. 2008

Thorax

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Background: 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). Methods: 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 >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 (5 days versus .5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis.Results: 21 studies with a total of 10 698 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 (,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) and the summary OR for bacteriological cure was 1.05 (95% CI 0.87 to 1.26). 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. Conclusions: 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.

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Value of ampicillin in the hospital treatment of exacerbations of chronic bronchitis.

Cited by 89 publications

References 6 publications

Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review

Exacerbations of chronic obstructive pulmonary disease: when are antibiotics indicated? A systematic review

Canadian Guidelines for the Management of Acute Exacerbations of Chronic Bronchitis

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

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