Cochrane for Clinicians

Putting Evidence into Practice

Prophylactic Antibiotics for the Prevention of COPD Exacerbation



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Am Fam Physician. 2014 Jun 1;89(11):870.

This clinical content conforms to AAFP criteria for continuing medical education (CME). See CME Quiz Questions.

Author disclosure: No relevant financial affiliations.

Clinical Question

Can prophylactic antibiotics decrease chronic obstructive pulmonary disease (COPD) exacerbations in a 67-year-old man with a history of frequent exacerbations?

Evidence-Based Answer

Continuous prophylactic antibiotic therapy significantly decreases COPD exacerbations for up to three years. However, it does not decrease mortality, and it puts the patient at risk of antibiotic-resistant colonization and infection. (Strength of Recommendation: B, based on inconsistent or limited-quality patient-oriented evidence.)

Practice Pointers

COPD occurs in approximately 40% of smokers, affects more men than women, and is more common among those living in urban areas.1 The economic burden in the United States is as much as $49.5 billion annually, with most of this cost devoted to treating exacerbations.1 Current guidelines recommend preventive measures to limit exacerbations, including


The practice recommendations in this activity are available at http://summaries.cochrane.org/CD009764.

SOURCE:

Herath SC, Poole P. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2013;(11):CD009764.

REFERENCE

1. Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global Strategy for the Diagnosis, Management, and Prevention of COPD. 2014. http://www.goldcopd.org/. Accessed April 15, 2014.

These are summaries of reviews from the Cochrane Library.

The series coordinator for AFP is Corey D. Fogleman, MD, Lancaster General Hospital Family Medicine Residency, Lancaster, Pa.

A collection of Cochrane for Clinicians published in AFP is available at http://www.aafp.org/afp/cochrane.



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