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COPD exacerbation and antibiotics

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
https://www.readbyqxmd.com/read/27762515/a-cross-sectional-cohort-analyses-assessing-response-to-levosalbutamol-bronchodilatory-cough-formulations-in-outpatient-community-settings-of-india-bus-analyses
#9
A Vora, Amit Bhargava
INTRODUCTION: Cough is significant health problem with greater implication for impaired quality of life. Acute and chronic cough due to infective (viral/bacterial), allergic conditions or bronchial asthma including cough variant asthma are often treated with combination of mucolytics, expectorants and bronchodilators. Bronchodilators reduces cough sensitivity, promotes clearance of cough secretions while reducing protrusive inflammatory mediator release. AIMS AND OBJECTIVES: To further understand the clinical utility and safety of Bronchodilatory cough formulations (BCF) containing Levosalbutamol in real world settings...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27737686/effectiveness-of-a-pharmacist-driven-intervention-in-copd-epic-study-protocol-for-a-randomized-controlled-trial
#10
Erin Davis, Carlo Marra, John-Michael Gamble, Jamie Farrell, Joe Lockyer, J Mark FitzGerald, Waseem Abu-Ashour, Charlie Gillis, John Hawboldt
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) are often nonadherent with medications and have poor inhaler technique. Community pharmacists can help to improve health-related quality of life and overall outcomes in patients with COPD. We aim to measure the effectiveness of a systematic, pharmacist-driven intervention on patients with diagnosed COPD. METHODS/DESIGN: This pragmatic, parallel-group, cluster randomized controlled trial is designed to determine the effectiveness of a multifactorial, pharmacist-led intervention on medication adherence, inhaler technique, health-related quality of life, health care resource utilization including COPD exacerbations, and use of medications...
October 13, 2016: Trials
https://www.readbyqxmd.com/read/27734780/-is-procalcitonin-measurement-useful-in-managing-respiratory-tract-infections
#11
J M Prins, T van der Poll
Better use of current antibiotics is warranted to curb increasing antimicrobial resistance rates. Procalcitonin guidance can safely reduce antibiotic usage when used to initiate or discontinue antibiotics in adult patients with a respiratory tract infection. However, the claimed reductions in antibiotic usage are mainly achieved in patients with acute bronchitis and exacerbations of COPD, conditions for which guidelines already discourage antibiotic treatment. Sequential procalcitonin measurements can also reduce the treatment duration of community-acquired pneumonia from 10-12 to 5-7 days, which is, however, already the recommended treatment duration for in- and outpatients under the current Dutch guidelines...
2016: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/27722084/shortness-of-breath-patient-history-not-always-indicative-of-the-cause
#12
Tony S Brar, Neeka Akhavan
This is a 78 year old male with a past medical history of coronary artery disease (CAD), chronic obstructive pulmonary disease (COPD), hypertension (HTN), and gastroesophageal reflux disorder (GERD) who presented to the emergency room with worsening shortness of breath (SOB) and low-grade fevers for one week prior to admission. He was originally diagnosed with healthcare associated pneumonia (HCAP) and an acute on chronic COPD exacerbation and treated with prednisone, inhalers, ipratropium/albuterol, and broad-spectrum antibiotics...
2016: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27701886/nodular-colitis-endoscopic-image-an-unusual-finding
#13
L A Loza Vargas, Henar Núñez Rodríguez, Marina Benito Sanz, Tomás Zamora Martínez, Pilar Díez Redondo, Manuel Pérez Miranda
An 82-year-old male with a history of high blood pressure, COPD, chronic myeloid leukemia, and stage-4 chronic renal failure. Admitted to hospital for lower-limb cellulitis and severe COPD exacerbation, he received antibiotic therapy and bronchodilators. During his hospital stay he developed severe anemia and had an hematochezia event with no diarrhea. A complete colonoscopy found small (4-7 mm) nacreous elevated lesions, circumferential in shape, in the cecum and ascending colon with some bleeding stigmata and submucosal bleeding suggestive of infectious colitis; stool culture was negative and Clostridium difficile toxins were positive...
October 2016: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/27677845/resveratrol-suppresses-nthi-induced-inflammation-via-up-regulation-of-the-negative-regulator-myd88-short
#14
Carla S Andrews, Shingo Matsuyama, Byung-Cheol Lee, Jian-Dong Li
Upper respiratory tract inflammatory diseases such as asthma and chronic obstructive pulmonary diseases (COPD) affect more than one-half billion people globally and are characterized by chronic inflammation that is often exacerbated by respiratory pathogens such as nontypeable Haemophilus influenzae (NTHi). The increasing numbers of antibiotic-resistant bacterial strains and the limited success of currently available pharmaceuticals used to manage the symptoms of these diseases present an urgent need for the development of novel anti-inflammatory therapeutic agents...
September 28, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27613392/pharmacological-strategies-to-reduce-exacerbation-risk-in-copd-a-narrative-review
#15
REVIEW
Marc Miravitlles, Anthony D'Urzo, Dave Singh, Vladimir Koblizek
Identifying patients at risk of exacerbations and managing them appropriately to reduce this risk represents an important clinical challenge. Numerous treatments have been assessed for the prevention of exacerbations and their efficacy may differ by patient phenotype. Given their centrality in the treatment of COPD, there is strong rationale for maximizing bronchodilation as an initial strategy to reduce exacerbation risk irrespective of patient phenotype. Therefore, in patients assessed as frequent exacerbators (>1 exacerbation/year) we propose initial bronchodilator treatment with a long-acting muscarinic antagonist (LAMA)/ long-acting β2-agonist (LABA)...
September 10, 2016: Respiratory Research
https://www.readbyqxmd.com/read/27609596/introduction-of-a-pct-based-algorithm-to-guide-antibiotic-prescription-in-copd-exacerbation
#16
J Picart, M P Moiton, B-A Gaüzère, V Gazaille, X Combes, S DiBernardo
OBJECTIVES: Prescribing antibiotics for COPD exacerbations is not easy. Procalcitonin (PCT) is a useful biomarker that helps reduce the rate of antibiotic therapies. However, its proper cut-off levels are often unknown. We aimed to assess the impact of a PCT-based algorithm to guide antibiotic therapy prescription in COPD exacerbations. METHODS: We conducted an observational, retrospective, and before/after study. We reviewed physician practices regarding PCT test and antibiotic therapy prescription to all patients hospitalized for COPD exacerbation...
December 2016: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/27586869/different-dyspnoea-perception-in-copd-patients-with-frequent-and-infrequent-exacerbations
#17
Giulia Scioscia, Isabel Blanco, Ebymar Arismendi, Felip Burgos, Concepción Gistau, Maria Pia Foschino Barbaro, Bartolome Celli, Denis E O'Donnell, Alvar Agustí
BACKGROUND: Some patients with COPD report frequent acute exacerbations (AECOPD) of the disease (FE), whereas others suffer them infrequently (IE). Because the current diagnosis of exacerbation relies on patient's perception of increased symptoms (mostly dyspnoea), we hypothesised that dyspnoea perception might be different in COPD patients with FE (≥2 exacerbations or 1 hospitalisation due to AECOPD in the previous year) or IE (≤1 exacerbation in the previous year), AECOPD being defined by the institution antibiotics and/or steroids treatment, or hospital admission...
September 1, 2016: Thorax
https://www.readbyqxmd.com/read/27579823/biomarkers-predictive-of-exacerbations-in-the-spiromics-and-copdgene-cohorts
#18
Jason D Keene, Sean Jacobson, Katerina Kechris, Gregory L Kinney, Marilyn G Foreman, Claire M Doerschuk, Barry J Make, Jeffrey L Curtis, Stephen I Rennard, R Graham Barr, Eugene R Bleecker, Richard E Kanner, Eric C Kleerup, Nadia N Hansel, Prescott G Woodruff, MeiLan K Han, Robert Paine Iii, Fernando J Martinez, Russell P Bowler, Wanda K O'Neal
RATIONALE: COPD exacerbations are associated with disease progression, higher healthcare cost, and increased mortality. Published predictors of future exacerbations include previous exacerbation, airflow obstruction, poor overall health, home oxygen use, and gastroesophageal reflux. The value of adding blood biomarkers to clinical variables to predict exacerbations remains unproven. METHODS: Subjects from SPIROMICS (n=1544) and COPDGene (n=602) cohorts had 90 plasma or serum candidate proteins measured on study entry using Myriad-RBM multiplex panels...
August 31, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27574418/efficacy-of-a-self-management-plan-in-exacerbations-for-patients-with-advanced-copd
#19
Juan Miguel Sánchez-Nieto, Rubén Andújar-Espinosa, Roberto Bernabeu-Mora, Chunshao Hu, Beatriz Gálvez-Martínez, Andrés Carrillo-Alcaraz, Carlos Federico Álvarez-Miranda, Olga Meca-Birlanga, Eva Abad-Corpa
BACKGROUND: Self-management interventions improve different outcome variables in various chronic diseases. Their role in COPD has not been clearly established. We assessed the efficacy of an intervention called the self-management program on the need for hospital care due to disease exacerbation in patients with advanced COPD. METHODS: Multicenter, randomized study in two hospitals with follow-up of 1 year. All the patients had severe or very severe COPD, and had gone to either an accident and emergency (A&E) department or had been admitted to a hospital at least once in the previous year due to exacerbation of COPD...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27574416/effects-of-roflumilast-in-copd-patients-receiving-inhaled-corticosteroid-long-acting-%C3%AE-2-agonist-fixed-dose-combination-re-2-spond-rationale-and-study-design
#20
Stephen I Rennard, Fernando J Martinez, Klaus F Rabe, Sanjay Sethi, Emilio Pizzichini, Andrew McIvor, Shahid Siddiqui, Antonio Anzueto, Haiyuan Zhu
BACKGROUND: Roflumilast, a once-daily, selective phosphodiesterase-4 inhibitor, reduces the risk of COPD exacerbations in patients with severe COPD associated with chronic bronchitis and a history of exacerbations. The RE(2)SPOND study is examining whether roflumilast, when added to an inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) fixed-dose combination (FDC), further reduces exacerbations. The methodology is described herein. METHODS: In this Phase IV, multicenter, double-blind, placebo-controlled, parallel-group trial, participants were randomized 1:1 (stratified by long-acting muscarinic antagonist use) to receive roflumilast or placebo, plus ICS/LABA FDC, for 52 weeks...
2016: International Journal of Chronic Obstructive Pulmonary Disease
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