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Quick Use of Antibiotics Best for COPD Flare-Ups
Date:5/25/2010

Not waiting to confirm an infection improves patient outcomes, researchers say

TUESDAY, May 25 (HealthDay News) -- People hospitalized with the lung ailment chronic obstructive pulmonary disease (COPD) do better when they receive antibiotics without delay, a new study shows.

COPD patients who were given antibiotics early in their hospital stay were less likely to need mechanical ventilation and less likely to have to be readmitted to the hospital, the researchers said.

The finding could have implications for routine treatment, since "current guidelines for treating COPD exacerbations recommend antibiotics only for patients who have an increase in sputum or purulent [pus-bearing] sputum," said lead researcher Dr. Michael B. Rothberg, from Baystate Medical Center in Springfield, Mass.

"We looked to see if we could identify a group of patients who would not benefit from antibiotics, but we couldn't find one," Rothberg said.

This is not to say that all COPD patients will benefit from antibiotics, Rothberg added. "At present, we only think that about half of COPD exacerbations are caused by infection, so probably only half of patients can benefit from this therapy. The problem is that we don't know which half," he said.

The findings were published in the May 26 issue of the Journal of the American Medical Association.

COPD typically involves a combination of bronchitis and emphysema and is often tied to smoking. The disease affects some 12 million people in the United States and is the fourth leading cause of death, according to background information with the study.

According to Rothberg's group, exacerbations of COPD are responsible for more than 600,000 hospitalizations each year and result in direct costs of more than $20 billion.

For the study, Rothberg's team looked at the outcomes of almost 85,000 patients hospitalized for exacerbations of COPD in 4
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