Document Detail

Short-course antibiotic treatment in acute exacerbations of chronic bronchitis and COPD: a meta-analysis of double-blind studies.
MedLine Citation:
PMID:  18234905     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: A study was undertaken to determine whether a short course of antibiotic treatment (< or = 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 > or = 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 < or = 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.
R El Moussaoui; B M Roede; P Speelman; P Bresser; J M Prins; P M M Bossuyt
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review     Date:  2008-01-30
Journal Detail:
Title:  Thorax     Volume:  63     ISSN:  1468-3296     ISO Abbreviation:  Thorax     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-04-29     Completed Date:  2008-05-28     Revised Date:  2008-12-10    
Medline Journal Info:
Nlm Unique ID:  0417353     Medline TA:  Thorax     Country:  England    
Other Details:
Languages:  eng     Pagination:  415-22     Citation Subset:  IM    
Department of Internal Medicine, Division of Infectious Diseases, Tropical Medicine and AIDS and Center for Infection and Immunity Amsterdam (CINIMA), Amsterdam, The Netherlands.
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MeSH Terms
Anti-Bacterial Agents / administration & dosage*
Bronchitis, Chronic / drug therapy
Data Collection
Double-Blind Method
Drug Administration Schedule
Middle Aged
Pulmonary Disease, Chronic Obstructive / drug therapy*
Treatment Outcome
Reg. No./Substance:
0/Anti-Bacterial Agents
Comment In:
J Fam Pract. 2008 Nov;57(11):711-2   [PMID:  19023903 ]
Thorax. 2008 May;63(5):390-2   [PMID:  18443155 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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