Use of Antibiotics Best for COPD Flare-Ups

Patients hospitalized due to chronic obstructive pulmonary disease (COPD) may do better receiving antibiotics without delay, according to a new study published in the Journal of the American Medical Association. Researchers found that patients who were given antibiotics early in their stay were less likely to require mechanical ventilation and less likely to be readmitted to the hospital.

These findings may have implications for routine treatment, which currently utilizes antibiotics only for CPOD patients who have an increase in sputum or purulent (pus-bearing) sputum. They do not mean that all patients will benefit from antibiotics, however, as only about half of COPD exacerbations are thought to be caused by infection.

Researchers are unsure as to which half of COPD patients will benefit from this treatment—those with exacerbations caused by infection, or those without.

According to researchers, exacerbations of COPD are responsible for more than 600,000 hospitalizations each year and result in direct costs of more than $20 billion. The research team studied the outcomes of almost 85,000 patients hospitalized in more than 400 U.S. hospitals over a period of almost two years.

Although 79% of patients received antibiotics for at least two days, the timing of treatment was critical to their outcome. Researchers found that fewer patients whose antibiotic therapy started in the first two days after admission needed to be put on a mechanical ventilator than patients whose treatment started later. In addition, fewer patients who received early treatment saw fatal outcomes or treatment failures. They also saw a lower rate of hospital readmission for acute exacerbations of COPD.

Though further study is needed, researchers expect that all patients requiring hospitalization due to COPD exacerbations will benefit from early administration of antibiotics.

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