Details

Autor(en) / Beteiligte

• El Moussaoui, R
• Roede, B M
• Speelman, P
• Bresser, P
• Prins, J M
• Bossuyt, P M M

Titel

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies

Ist Teil von

• Thorax, 2008-05, Vol.63 (5), p.415-422

Ort / Verlag

London: BMJ Publishing Group Ltd and British Thoracic Society

Erscheinungsjahr

2008

Quelle

BMJ Journals Archiv - DFG Nationallizenzen

Beschreibungen/Notizen

• Background:A study was undertaken to determine whether a short course of antibiotic treatment (⩽5 days) is as effective as the conventional longer treatment in acute exacerbations of chronic bronchitis and chronic obstructive pulmonary disease (COPD).Methods:MEDLINE, EMBASE and the Cochrane central register of controlled trials were searched to July 2006. Studies considered eligible were double-blind randomised clinical trials including adult patients ⩾18 years of age with a clinical diagnosis of exacerbation of COPD or chronic bronchitis, no antimicrobial therapy at the time of diagnosis and random assignment to antibiotic treatment for ⩽5 days versus >5 days. The primary outcome measure was clinical cure at early follow-up on an intention-to-treat basis.Results:21 studies with a total of 10 698 patients were included. The average quality of the studies was high: the mean (SD) Jadad score was 3.9 (0.9). At early follow-up (<25 days), the summary odds ratio (OR) for clinical cure with short treatment versus conventional treatment was 0.99 (95% CI 0.90 to 1.08). At late follow-up the summary OR was 1.0 (95% CI 0.91 to 1.10) and the summary OR for bacteriological cure was 1.05 (95% CI 0.87 to 1.26). Similar summary ORs were observed for early cure in trials with the same antibiotic in both arms and in studies grouped by the antibiotic class used in the short-course arm.Conclusions:A short course of antibiotic treatment is as effective as the traditional longer treatment in patients with mild to moderate exacerbations of chronic bronchitis and COPD.