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COPD exacerbation and antibiotics

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https://www.readbyqxmd.com/read/29747278/-the-associations-between-comorbidity-and-exacerbation-risk-in-patients-with-chronic-obstructive-pulmonary-disease
#1
Y L Huang, B Mao, J Mim, G H Li, Y Q Zheng, L H Wu, S J Wang, B Qu, J J Fu
Objective: To study the association between comorbidity and acute exacerbation risk in patients with chronic obstructive pulmonary disease (COPD). Methods: This was a prospective cohort study with 64 stable COPD patients included. There were 64 males and 18 females with an average age of (68±9) years. Clinical characteristics, the number and type of comorbidities were recorded, and Charlson comorbidity index (CCI) was calculated. The patients were interviewed by phone calls every 3 months since baseline in which the number of acute exacerbations was recorded until 12 months...
May 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29731926/practical-approach-to-lung-health-experience-from-the-republic-of-macedonia
#2
Biljana Ilievska-Poposka, Maja Zakoska, Stefan Talevski
BACKGROUND: Among the adults and children aged 5 yrs who attend PHC settings, 20-30% seeks to care for respiratory symptoms. Over 80-90% of the respiratory patients suffer from acute respiratory infections (ARI), followed by chronic obstructive pulmonary diseases (COPD), asthma, and less frequently with pneumonia and tuberculosis (TB). To improve the quality of care in patients who seek assistance for respiratory symptoms in PHC settings and the efficiency of respiratory service delivery within healthcare systems, WHO has designated several initiatives among which one is PAL (Practical Approach to Lung Health)...
April 15, 2018: Open Access Macedonian Journal of Medical Sciences
https://www.readbyqxmd.com/read/29719385/treatment-of-exacerbations-as-a-predictor-of-subsequent-outcomes-in-patients-with-copd
#3
Peter Ma Calverley, Antonio R Anzueto, Daniel Dusser, Achim Mueller, Norbert Metzdorf, Robert A Wise
Rationale: Exacerbations of COPD are managed differently, but whether treatment of one exacerbation predicts the likelihood of subsequent events is unknown. Objective: We examined whether the treatment given for exacerbations predicted subsequent outcomes. Methods: This was a post-hoc analysis of 17,135 patients with COPD from TIOtropium Safety and Performance In Respimat® (TIOSPIR® ). Patients treated with tiotropium with one or more moderate to severe exacerbations on study were analyzed using descriptive statistics, logistic and Cox regression analysis, and Kaplan-Meier plots...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29692607/exacerbation-heterogeneity-in-copd-subgroup-analyses-from-the-flame-study
#4
Claus F Vogelmeier, Kenneth R Chapman, Marc Miravitlles, Nicolas Roche, Jørgen Vestbo, Chau Thach, Donald Banerji, Robert Fogel, Francesco Patalano, Petter Olsson, Konstantinos Kostikas, Jadwiga A Wedzicha
Background: The FLAME study compared once-daily indacaterol/glycopyrronium (IND/GLY) 110/50 μg with twice-daily salmeterol/fluticasone (SFC) 50/500 μg in symptomatic patients with moderate to very severe COPD and a history of exacerbations in the previous year. Methods: This prespecified and post hoc subgroup analysis evaluated treatment efficacy on 1) moderate/severe exacerbations according to prior exacerbation history and treatment, and 2) types of exacerbations according to health care resource utilization (HCRU) during 1-year follow-up...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29671491/antibiotic-prophylaxis-for-copd-exacerbations
#5
Corey Lyon, Henry Colangelo, Kristen DeSanto
No abstract text is available yet for this article.
April 15, 2018: American Family Physician
https://www.readbyqxmd.com/read/29663044/procalcitonin-algorithm-to-guide-initial-antibiotic-therapy-in-acute-exacerbations-of-copd-admitted-to-the-icu-a-randomized-multicenter-study
#6
Cédric Daubin, Xavier Valette, Fabrice Thiollière, Jean-Paul Mira, Pascal Hazera, Djillali Annane, Vincent Labbe, Bernard Floccard, François Fournel, Nicolas Terzi, Damien Du Cheyron, Jean-Jacques Parienti
PURPOSE: To compare the efficacy of an antibiotic protocol guided by serum procalcitonin (PCT) with that of standard antibiotic therapy in severe acute exacerbations of COPD (AECOPDs) admitted to the intensive care unit (ICU). METHODS: We conducted a multicenter, randomized trial in France. Patients experiencing severe AECOPDs were assigned to groups whose antibiotic therapy was guided by (1) a 5-day PCT algorithm with predefined cutoff values for the initiation or stoppage of antibiotics (PCT group) or (2) standard guidelines (control group)...
April 16, 2018: Intensive Care Medicine
https://www.readbyqxmd.com/read/29618675/prevalence-of-escherichia-coli-resistant-to-beta-lactam-antibiotics-among-patients-with-chronic-obstructive-pulmonary-disease-and-urinary-tract-infection
#7
Emilija Nikolić, Tijana Brandmajer, Vesna Bokan, Maria Ulyashova, Maya Rubtsova
Urinary tract infection (UTI), which is typically caused by Escherichia coli (E. coli), is an insufficiently recognized co-morbidity among patients with chronic obstructive pulmonary disease (COPD). Adequate treatment can be complicated by resistance of the causative pathogen to beta-lactam antibiotics, which often produce beta-lactamase enzymes that destroy the antibiotic. The beta-lactamase family of enzymes is extremely diverse, including different types of enzyme and mutant forms. In this study, we analyzed 580 patients with COPD (236 females and 344 males) and thus found 218 patients with co-morbid UTIs, including 58 patients with UTI caused by E...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29615101/aspergillus-fumigatus-during-copd-exacerbation-a-pair-matched-retrospective-study
#8
Xunliang Tong, Anqi Cheng, Hongtao Xu, Jin Jin, Yimeng Yang, Sainan Zhu, Yanming Li
BACKGROUND: Recently awareness of the importance of Aspergillus colonization in the airway of patients with chronic obstructive pulmonary disease (COPD) was rising. The aim of this study was to investigate the clinical features and short-term outcomes of COPD patients with Aspergillus colonization during acute exacerbation. METHODS: A pair-matched retrospective study on patients presenting with COPD exacerbation was conducted from January 2014 to March 2016 in Beijing Hospital, China...
April 3, 2018: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29584453/rural-residence-and-copd-exacerbations-analysis-of-the-spiromics-cohort
#9
Robert M Burkes, Amanda J Gassett, Agathe S Ceppe, Wayne Anderson, Wanda K O'Neal, Prescott G Woodruff, Jerry A Krishnan, R Graham Barr, MeiLan K Han, Fernando J Martinez, Alejandro P Comellas, Allison A Lambert, Joel D Kaufman, Mark T Dransfield, J Michael Wells, Richard E Kanner, Robert Paine, Eugene R Bleecker, Laura M Paulin, Nadia N Hansel, M Bradley Drummond
RATIONALE: Rural residence is associated with poor outcomes in several chronic diseases. The association between rural residence and chronic obstructive pulmonary disease (COPD) exacerbations remains unclear. OBJECTIVE: To determine the independent association between rural residence and COPD-related outcomes including COPD exacerbations, airflow obstruction and symptom burden. METHODS: A total of 1684 Subpopulations and Intermediate Outcome Measures in COPD Study (SPIROMICS) participants with FEV1/FVC<0...
March 27, 2018: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/29557669/telemonitoring-in-copd-the-chromed-study-a-randomized-clinical-trial
#10
Paul P Walker, Pasquale P Pompilio, Paolo Zanaboni, Trine S Bergmo, Kaiu Prikk, Andrei Malinovschi, Josep M Montserrat, Jo Middlemass, Silvana Šonc, Giulia Munaro, Dorjan Marušič, Ruth Sepper, Roberto Rosso, A Niroshan Siriwardena, Christer Janson, Ramon Farre, Peter M A Calverley, Raffaele L Dellaca'
RATIONALE: Early detection of COPD exacerbations using tele-monitoring of physiological variables might reduce the frequency of hospitalisation. OBJECTIVES: To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique (FOT) and cardiac parameters in older COPD patients with co-morbidities. METHODS: This multicentre, randomized clinical trial recruited 312 GOLD grade II-IV COPD patients (median age 71 years [IQR:66-76], 49...
March 20, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29553450/management-of-chronic-obstructive-pulmonary-disease-exacerbations-at-the-nasser-medical-complex-a-clinical-audit
#11
Maha Al-Faqawi, Yousef Abuowda, Alaa Eldeen Elmassry, Bettina Böttcher
BACKGROUND: The frequency and severity of chronic obstructive pulmonary disease (COPD) exacerbations are the most important determinants of prognosis in COPD. The aim of this study was to assess the management of patients presenting with COPD exacerbations at the Nasser Medical Complex in the Gaza Strip and to compare the management with the Global Initiative for Chronic Obstructive Lung Disease guidelines (GOLD 2015). METHODS: We reviewed the medical records of all patients admitted to Nasser Medical Complex and diagnosed with COPD exacerbation between Jan 1, 2014, and Dec 31, 2016...
February 21, 2018: Lancet
https://www.readbyqxmd.com/read/29553157/different-durations-of-corticosteroid-therapy-for-exacerbations-of-chronic-obstructive-pulmonary-disease
#12
REVIEW
Julia Ae Walters, Daniel J Tan, Clinton J White, Richard Wood-Baker
BACKGROUND: Current guidelines recommend that patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) should be treated with systemic corticosteroid for seven to 14 days. Intermittent systemic corticosteroid use is cumulatively associated with adverse effects such as osteoporosis, hyperglycaemia and muscle weakness. Shorter treatment could reduce adverse effects. OBJECTIVES: To compare the efficacy of short-duration (seven or fewer days) and conventional longer-duration (longer than seven days) systemic corticosteroid treatment of adults with acute exacerbations of COPD...
March 19, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29540496/exacerbations-of-copd
#13
Christian Viniol, Claus F Vogelmeier
Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. While COPD is a mainly chronic disease, a substantial number of patients suffer from exacerbations. Severe exacerbations are related to a significantly worse survival outcome. This review summarises the current knowledge on the different aspects of COPD exacerbations. The impact of risk factors and triggers such as smoking, severe airflow limitation, bronchiectasis, bacterial and viral infections and comorbidities is discussed...
March 31, 2018: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/29523532/treatment-patterns-for-patients-hospitalized-with-chronic-obstructive-pulmonary-disease
#14
Alpesh N Amin, Vamsi Bollu, Michael D Stensland, Logan Netzer, Vaidyanathan Ganapathy
PURPOSE: Medication treatment patterns for chronic obstructive pulmonary disease (COPD) in inpatient settings were examined, as were the characteristics of patients treated with long-acting bronchodilators (LABDs) during hospitalization. METHODS: This retrospective study was conducted using inpatient administrative data from hospitals and medical centers nationwide. All patients discharged from the hospital from January 1, 2010, through December 31, 2012, who were at least 40 years of age, had a primary discharge diagnosis of COPD or a secondary diagnosis of COPD with a primary diagnosis of a respiratory condition, and treatment with a bronchodilator were included...
March 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29489922/update-in-hospital-medicine-practical-lessons-from-the-literature
#15
Alfred Burger, Chad Miller, Bradley A Sharpe, Rachel E Thompson
BACKGROUND: Hospital Medicine has a widening scope of practice. This article provides a summary of recent highimpact publications for busy clinicians who provide care to hospitalized adults. METHODS: The authors reviewed articles published between March 2016 and March 2017 for the Update in Hospital Medicine presentations at the 2017 Society of Hospital Medicine and Society of General Internal Medicine annual meetings. Nine of the 20 articles presented were selected for this review based on the article quality and potential to influence practice...
February 27, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29485951/predicting-acute-exacerbations-in-chronic-obstructive-pulmonary-disease
#16
Jennifer C Samp, Min J Joo, Glen T Schumock, Gregory S Calip, A Simon Pickard, Todd A Lee
BACKGROUND: With increasing health care costs that have outpaced those of other industries, payers of health care are moving from a fee-for-service payment model to one in which reimbursement is tied to outcomes. Chronic obstructive pulmonary disease (COPD) is a disease where this payment model has been implemented by some payers, and COPD exacerbations are a quality metric that is used. Under an outcomes-based payment model, it is important for health systems to be able to identify patients at risk for poor outcomes so that they can target interventions to improve outcomes...
March 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29463692/prophylactic-antibiotic-use-in-copd-and-the-potential-anti-inflammatory-activities-of-antibiotics
#17
REVIEW
Anthony W Huckle, Lucy C Fairclough, Ian Todd
Antibiotics have previously demonstrated anti-inflammatory properties, and they have been linked to therapeutic benefit in several pulmonary conditions that feature inflammation. Previous research suggests that these anti-inflammatory properties may be beneficial in the treatment of COPD. This review assesses the potential benefit of prophylactic, long-term, and low-dose antibiotic therapy in COPD, and whether any effects seen are anti-inflammatory in nature. Randomized, controlled trials comparing antibiotic therapy with placebo in subjects with stable COPD were evaluated...
May 2018: Respiratory Care
https://www.readbyqxmd.com/read/29442524/exacerbations-of-chronic-obstructive-pulmonary-disease-and-cardiac-events-a-cohort-analysis
#18
Ken M Kunisaki, Mark T Dransfield, Julie A Anderson, Robert D Brook, Peter M A Calverley, Bartolome R Celli, Courtney Crim, Benjamin F Hartley, Fernando J Martinez, David E Newby, Alexa A Pragman, Jørgen Vestbo, Julie C Yates, Dennis E Niewoehner
RATIONALE: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common, associated with acute inflammation, and may increase subsequent cardiovascular disease (CVD) risk. OBJECTIVE: Determine if AECOPD events are associated with increased risk of subsequent CVD. METHODS: A secondary cohort analysis of the Study to Understand Mortality and MorbidITy (SUMMIT) trial, a convenience sample of current/former smokers with moderate COPD from 1,368 centers in 43 countries...
February 14, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29411860/self-management-for-bronchiectasis
#19
REVIEW
Carol Kelly, Seamus Grundy, Dave Lynes, David Jw Evans, Sharada Gudur, Stephen J Milan, Sally Spencer
BACKGROUND: Bronchiectasis is a long term respiratory condition with an increasing rate of diagnosis. It is associated with persistent symptoms, repeated infective exacerbations, and reduced quality of life, imposing a burden on individuals and healthcare systems. The main aims of therapeutic management are to reduce exacerbations and improve quality of life. Self-management interventions are potentially important for empowering people with bronchiectasis to manage their condition more effectively and to seek care in a timely manner...
February 7, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29404940/impact-of-procalcitonin-guidance-on-management-of-adults-hospitalized-with-chronic-obstructive-pulmonary-disease-exacerbations
#20
Derek N Bremmer, Briana E DiSilvio, Crystal Hammer, Moeezullah Beg, Swati Vishwanathan, Daniel Speredelozzi, Matthew A Moffa, Kurt Hu, Rasha Abdulmassih, Jina T Makadia, Rikinder Sandhu, Mouhib Naddour, Noreen H Chan-Tompkins, Tamara L Trienski, Courtney Watson, Terrence J Obringer, Jim Kuzyck, Thomas L Walsh
BACKGROUND: Antibiotics are often prescribed for hospitalized patients with chronic obstructive pulmonary disease (COPD) exacerbations. The use of procalcitonin (PCT) in the management of pneumonia has safely reduced antibiotic durations, but limited data on the impact of PCT guidance on the management of COPD exacerbations remain. OBJECTIVE: To determine the impact of PCT guidance on antibiotic utilization for hospitalized adults with exacerbations of COPD. DESIGN: A retrospective, pre-/post-intervention cohort study was conducted to compare the management of patients admitted with COPD exacerbations before and after implementation of PCT guidance...
May 2018: Journal of General Internal Medicine
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