Short antibiotic course effective in COPD flare-ups

By David Douglas

NEW YORK (Reuters Health) - In people who suffer flare-ups of chronic obstructive pulmonary disease, or COPD, a short course of antibiotics is as effective as a standard longer course, Dutch researchers report.

People with COPD, which includes chronic bronchitis and emphysema, are prone to sudden worsening of breathlessness. Pooled data from controlled trials, Ms. B. M. Roede told Reuters Health, "supports the effectiveness of short-course treatment in mild to moderate exacerbations of COPD or chronic bronchitis."

This is the case, she noted, when the exacerbations are characterized by at least two of the following symptoms: increased cough and difficulty breathing and increased sputum production and increased pus production.

Roede of the University of Amsterdam and colleagues reviewed the results of 21 studies involving more than 10,000 adults who had been randomly assigned to antibiotic treatment for 5 days or less or for more than 5 days.

They found that the shorter course of antibiotics was as effective as the standard longer course.

"Based on the included studies," said Roede, "it seems that the duration of antibiotic treatment can be safely reduced. We therefore propose that the guidelines for COPD should recommend antibiotic treatment duration of no longer than 5 days, regardless of antibiotic class."

SOURCE: Thorax, May 2008.