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COPD exacerbation and antibiotics

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https://www.readbyqxmd.com/read/28212436/antibody-deficiency-in-patients-with-frequent-exacerbations-of-chronic-obstructive-pulmonary-disease-copd
#1
Brian N McCullagh, Alejandro P Comellas, Zuhair K Ballas, John D Newell, M Bridget Zimmerman, Antoine E Azar
Chronic Obstructive Pulmonary Disease is the third leading cause of death in the US, and is associated with periodic exacerbations, which account for the largest proportion of health care utilization, and lead to significant morbidity, mortality, and worsening lung function. A subset of patients with COPD have frequent exacerbations, occurring 2 or more times per year. Despite many interventions to reduce COPD exacerbations, there is a significant lack of knowledge in regards to their mechanisms and predisposing factors...
2017: PloS One
https://www.readbyqxmd.com/read/28144133/real-life-data-on-antibiotic-prescription-and-sputum-culture-diagnostics-in-acute-exacerbations-of-copd-in-primary-care
#2
Erik Bathoorn, Feikje Groenhof, Ron Hendrix, Thys van der Molen, Bhanu Sinha, Huib Am Kerstjens, Alex W Friedrich, Janwillem Wh Kocks
BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are generally treated with optimization of bronchodilation therapy and a course of oral corticosteroids, mostly without antibiotics. The Dutch guidelines recommend prudent use of antibiotics, with amoxicillin or doxycycline as first choice. Here we evaluate adherence to these guidelines with regard to antibiotic prescription in AECOPD in primary care and the use of sputum cultures. METHODS: We retrospectively analyzed a longitudinal cohort of patients in three primary care practices in the north-eastern region of the Netherlands from 2009 to 2013 (n=36,172 subjects) participating in the Registration Network Groningen...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28143877/procalcitonin-to-guide-antibiotic-administration-in-copd-exacerbations-a-meta-analysis
#3
REVIEW
Alexander G Mathioudakis, Victoria Chatzimavridou-Grigoriadou, Alexandru Corlateanu, Jørgen Vestbo
Challenges in the differentiation of the aetiology of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) have led to significant overuse of antibiotics. Serum procalcitonin, released in response to bacterial infections, but not viral infections, could possibly identify AECOPD requiring antibiotics. In this meta-analysis we assessed the clinical effectiveness of procalcitonin-based protocols to initiate or discontinue antibiotics in patients presenting with AECOPD.Based on a prospectively registered protocol, we reviewed the literature and selected randomised or quasi-randomised trials comparing procalcitonin-based protocols to initiate or discontinue antibiotics versus standard care in AECOPD...
January 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28139873/impact-of-exacerbations-on-adherence-and-outcomes-of-pulmonary-rehabilitation-in-patients-with-copd
#4
Dionne C W Braeken, Martijn A Spruit, Sarah Houben-Wilke, Dionne E Smid, Gernot G U Rohde, Emiel F M Wouters, Frits M E Franssen
BACKGROUND AND OBJECTIVE: Dropout or lack of response is an important issue in pulmonary rehabilitation (PR), which underlines the need to identify predictors of dropout and response. Acute exacerbations (AEs) of COPD may influence dropout rates and PR response. We aimed to assess differences in dropout and outcomes of PR between COPD with and without AEs. METHODS: Clinically stable patients with moderate-to-very severe COPD (age: 64.1 ± 9.1 years, 55.6% males, forced expiratory volume in 1 s (FEV1 ): 48...
January 31, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28137501/a-randomised-phase-iii-trial-of-once-daily-fluticasone-furoate-vilanterol-100-25%C3%A2-%C3%AE-g-versus-once-daily-vilanterol-25%C3%A2-%C3%AE-g-to-evaluate-the-contribution-on-lung-function-of-fluticasone-furoate-in-the-combination-in-patients-with-copd
#5
Thomas M Siler, Atsushi Nagai, Catherine A Scott-Wilson, Dawn A Midwinter, Courtney Crim
BACKGROUND: The contribution of fluticasone furoate (FF) on lung function in the FF/vilanterol (VI) 100/25 μg combination has been demonstrated numerically, but not statistically. METHODS: This multicentre, randomised, double-blind, controlled trial (GlaxoSmithKline study number 200820; clinicaltrials.gov NCT02105974) enrolled ≥40-year-old patients with chronic obstructive pulmonary disease (COPD), a ≥10-pack-year smoking history, a post-bronchodilator forced expiratory volume in 1 s (FEV1) 30-70% of the predicted value, a FEV1/forced vital capacity ratio of ≤0...
February 2017: Respiratory Medicine
https://www.readbyqxmd.com/read/28122492/self-treatment-of-acute-exacerbations-of-chronic-obstructive-pulmonary-disease-requires-more-than-symptom-recognition-a-qualitative-study-of-copd-patients-perspectives-on-self-treatment
#6
Johanna Laue, Hasse Melbye, Mette Bech Risør
BACKGROUND: Self-treatment of acute exacerbations of COPD with antibiotics and/or oral corticosteroids has emerged as a promising strategy to reduce hospitalization rates, mortality and health costs. However, for reasons little understood, the effect of self-treatment, particularly when not part of comprehensive self-management programs, remains unclear. Therefore, this study aims to get insight into the patients' perspective on self-treatment of acute exacerbations of COPD, focusing specifically on how patients decide for the right moment to start treatment with antibiotics and/or oral corticosteroids, what they consider important when making this decision and aspects which might interfere with successful implementation...
January 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28093224/beta-2-adrenoreceptor-polymorphism-at-position-16-determines-the-clinical-severity-of-chronic-obstructive-pulmonary-disease
#7
Justyna Emeryk-Maksymiuk, Andrzej Emeryk, Paweł Krawczyk, Kamila Wojas-Krawczyk, Janusz Milanowski
The Arg/Arg homozygosity at codon 16 of the beta-2-adrenoreceptor (ADRB2) gene has been thought to predispose asthma patients to a poorer therapeutic response to beta-2-mimetics, or to worse control of the disease. In contrast, the results of the studies analysing the effect of ADRB2 polymorphisms on the response to beta-2-adrenoreceptor agonists in chronic obstructive pulmonary disease (COPD) patients are sparse and inconclusive. The aim of this research was to verify if p.Arg16Gly (c.46A > G) and p.Gly27Glu (c...
January 13, 2017: Pulmonary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28044184/-outcome-predictors-for-copd-patients-hospitalized-for-acute-exacerbation
#8
M Spielmanns, F Axer, C Nell, A R Koczulla, T Boeselt, F Magnet, J H Storre, W Windisch
BACKGROUND: Prognostic factors for clinical failure of acute exacerbation in patients with COPD (AECOPD) are of special importance in order to choose an adequate therapy and resources during inpatient treatment. Our database was analyzed to identify predictors for a negative outcome. MATERIALS AND METHODS: In a retrospective analysis medical records of 616 patients (299 women; 317 men) hospitalized for AECOPD between January 2011 and January 2016 were analyzed in order to evaluate demographic and clinical parameters leading to adverse events...
January 2, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28030992/macrolides-a-promising-pharmacologic-therapy-for-chronic-obstructive-pulmonary-disease
#9
Shilin Qiu, Xiaoning Zhong
Chronic inflammation plays a central role in the pathogenesis of chronic obstructive pulmonary disease (COPD). However, there are no effective anti-inflammatory pharmacologic therapies available for COPD so far. Recent evidence suggests that an immunologic mechanism has a role in the pathogenesis of COPD. Macrolides possess anti-inflammatory and immune-modulating effects may be helpful in the treatment of COPD. Several clinical studies have shown that long-term use of macrolides reduces the frequency of COPD exacerbations...
December 1, 2016: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/27994450/how-do-general-practitioners-implement-decision-making-regarding-copd-patients-with-exacerbations-an-international-focus-group-study
#10
Johanna Laue, Hasse Melbye, Peder A Halvorsen, Elena A Andreeva, Maciek Godycki-Cwirko, Anja Wollny, Nick A Francis, Mark Spigt, Kenny Kung, Mette Bech Risør
PURPOSE: To explore the decision-making of general practitioners (GPs) concerning treatment with antibiotics and/or oral corticosteroids and hospitalization for COPD patients with exacerbations. METHODS: Thematic analysis of seven focus groups with 53 GPs from urban and rural areas in Norway, Germany, Wales, Poland, Russia, the Netherlands, and Hong Kong. RESULTS: Four main themes were identified. 1) Dealing with medical uncertainty: the GPs aimed to make clear medical decisions and avoid unnecessary prescriptions and hospitalizations, yet this was challenged by uncertainty regarding the severity of the exacerbations and concerns about overlooking comorbidities...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27990628/action-plans-with-brief-patient-education-for-exacerbations-in-chronic-obstructive-pulmonary-disease
#11
REVIEW
Maxwell Howcroft, E Haydn Walters, Richard Wood-Baker, Julia Ae Walters
BACKGROUND: Exacerbations of chronic obstructive pulmonary disease (COPD) are a major driver of decline in health status and impose high costs on healthcare systems. Action plans offer a form of self-management that can be delivered in the outpatient setting to help individuals recognise and initiate early treatment for exacerbations, thereby reducing their impact. OBJECTIVES: To compare effects of an action plan for COPD exacerbations provided with a single short patient education component and without a comprehensive self-management programme versus usual care...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27987292/tracheomalacia-and-recurrent-exacerbations-of-chronic-obstructive-pulmonary-disease-a-case-report-and-review-of-the-literature
#12
Ghaly Kerolus, Ossama Ikladios
Chronic obstructive pulmonary disease (COPD) is one of the leading causes of disability and death worldwide. COPD exacerbation is usually treated with antibiotics, systemic corticosteroids, and inhaled bronchodilators. We present a case of recurrent COPD exacerbation that was treated repeatedly with standard therapy. Dynamic expiratory computed tomography of the chest was done, which revealed concomitant tracheomalacia. COPD and tracheomalacia may coexist during recurrent exacerbations of COPD, and delayed diagnosis can be associated with severe comorbidities...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27920515/effect-of-elom-080-on-exacerbations-and-symptoms-in-copd-patients-with-a-chronic-bronchitis-phenotype-a-post-hoc-analysis-of-a-randomized-double-blind-placebo-controlled-clinical-trial
#13
Kai-Michael Beeh, Jutta Beier, Henning Candler, Thomas Wittig
BACKGROUND: Treating symptoms and preventing exacerbations are key components of chronic obstructive pulmonary disease (COPD) long-term management. Recently, a more tailored treatment approach has been proposed, in particular for two well-established clinical phenotypes, frequent exacerbators and chronic bronchitis-dominant COPD. ELOM-080 has demonstrated clinical efficacy in treating symptoms and preventing exacerbations in subjects with chronic bronchitis. However, little is known about the potential effects of ELOM-080 in COPD patients...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27904601/evaluation-effects-of-nebulized-gentamicin-in-exacerbation-of-chronic-obstructive-lung-disease
#14
Forogh Soltaninejad, Soleiman Kheiri, Roya Habibian, Arshia Amra, Shahin Asgari-Savadjani
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Exacerbation of COPD has negative effect on quality of life. Therapeutic effect of nebulized antibiotics in pulmonary infections has been reported previously. Hence, we evaluated the effect of nebulized gentamicin in acute exacerbation of COPD (AECOPD). MATERIALS AND METHODS: In this clinical trial study, 86 hospitalized patients with AECOPD were divided into two groups for using nebulized gentamicin twice daily (case group) and placebo (control group) for 5 days in addition to standard treatment...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27900466/overview-of-the-impact-of-depression-and-anxiety-in-chronic-obstructive-pulmonary-disease
#15
Josep Montserrat-Capdevila, Pere Godoy, Josep Ramon Marsal, Ferran Barbé, Josep Pifarré, Miquel Alsedà, Marta Ortega
BACKGROUND: Anxiety and depression are common entities in patients diagnosed with COPD. However, the impact that they have on the exacerbation of illness is scarcely studied. OBJECTIVE: To determine if the presence of anxiety and depression is associated with a greater risk of frequent exacerbation (≥2 per year) in patients diagnosed with COPD. PATIENTS AND METHODS: A cohort study that analysed frequent exacerbation and associated factors in 512 patients monitored during 2 years...
November 29, 2016: Lung
https://www.readbyqxmd.com/read/27860342/compliance-with-a-copd-bundle-of-care-in-an-australian-emergency-department-a-cohort-study
#16
Alexis Gerber, Catriona Moynihan, Sharon Klim, Peter Ritchie, Anne-Maree Kelly
INTRODUCTION: Bundles of care are gaining popularity for treating acute severe illness. OBJECTIVE: To describe compliance with bundle of care elements (individually and as a "bundle") for patients treated for chronic obstructive pulmonary disease (COPD) exacerbations in the emergency department (ED). METHODS: Retrospective observational study of patients presenting in the 2014 calendar year with an ED diagnosis of COPD. The primary outcomes of interest were compliance with key bundle of care elements (individually and as a "bundle")...
November 18, 2016: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/27853362/comparative-analysis-of-budesonide-formoterol-and-fluticasone-salmeterol-combinations-in-copd-patients-findings-from-a-real-world-analysis-in-an-italian-setting
#17
Valentina Perrone, Diego Sangiorgi, Stefano Buda, Luca Degli Esposti
AIM: The objective of this study was to evaluate the different outcomes associated with the use of budesonide/formoterol compared to fluticasone/salmeterol in fixed combinations in patients with COPD in a "real-world" setting. The outcomes included exacerbation rates and health care costs. PATIENTS AND METHODS: An observational retrospective cohort analysis, based on administrative databases of three local health units, was conducted. Patients with at least one prescription of fixed-dose combination of inhaled corticosteroids and long-acting β2-agonists (budesonide/formoterol or fluticasone/salmeterol), at dosages and formulations approved for COPD in Italy, between January 1, 2009 and December 31, 2011 (inclusion period), were included...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27849733/53-influence-of-macrolide-antibiotics-on-outcomes-in-icu-patients-with-acute-exacerbations-of-copd
#18
Tyree Kiser, Marc Moss, Ellen Burnham, Michael Ho, R Vandivier
No abstract text is available yet for this article.
December 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27814579/the-emergence-of-aspergillus-species-in-chronic-respiratory-disease
#19
Anthony Ca Yii, Mariko S Koh, Therese S Lapperre, Gan L Tan, Sanjay H Chotirmall
Chronic lung disease is recognized as an important risk factor for developing pulmonary aspergillosis. The development of specific aspergillus-associated syndromes depends on host immunity and underlying lung disease. In the setting of asthma, hypersensitivity to Aspergillus can lead to allergic bronchopulmonary aspergillosis (ABPA) or severe asthma with fungal sensitization (SAFS). Chronic use of systemic or inhaled corticosteroids coupled with recurrent antibiotic use for exacerbations prevalent in chronic obstructive pulmonary disease (COPD) predisposes to chronic pulmonary aspergillosis (CPA)...
January 1, 2017: Frontiers in Bioscience (Scholar Edition)
https://www.readbyqxmd.com/read/27767328/effect-of-fluticasone-furoate-and-vilanterol-on-exacerbations-of-copd-in-patients-with-moderate-airflow-obstruction
#20
Fernando J Martinez, Jørgen Vestbo, Julie A Anderson, Robert D Brook, Bartolome R Celli, Nicholas J Cowans, Courtney Crim, Mark Dransfield, Sally Kilbride, Julie Yates, David E Newby, Dennis Niewoehner, Peter Ma Calverley
BACKGROUND: Inhaled corticosteroids have been shown to decrease exacerbations in COPD patients with moderate to severe COPD. Their effect in patients with milder airflow obstruction remains unclear. OBJECTIVE: This was an analysis of exacerbations in the Study to Understand Mortality and MorbidITy (SUMMIT) study. DESIGN: In a double-blind randomized controlled trial, once daily inhaled placebo, fluticasone furoate (FF, 100 μg), vilanterol (VI, 25 μg) or the combination (FF/VI) was administered...
October 21, 2016: American Journal of Respiratory and Critical Care Medicine
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