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Antibiotic prevention of acute exacerbations of COPD
Journal article   Peer reviewed

Antibiotic prevention of acute exacerbations of COPD

Richard P Wenzel, Alpha A Fowler and Michael B Edmond
New England Journal of Medicine, Vol.367(4), pp.340-347
2012
DOI: 10.1056/NEJMct1115170
PMID: 22830464
url
https://diposit.ub.edu/dspace/bitstream/2445/157357/1/617510.pdfView
Open Access

Abstract

A 55-year-old man with COPD presents with recurrent acute exacerbations despite compliance with appropriate therapy. Azithromycin prophylaxis is recommended since the drug has been shown to prevent acute exacerbations in such patients. Foreword This Journal feature begins with a case vignette that includes a therapeutic recommendation. A discussion of the clinical problem and the mechanism of benefit of this form of therapy follows. Major clinical studies, the clinical use of this therapy, and potential adverse effects are reviewed. Relevant formal guidelines, if they exist, are presented. The article ends with the authors' clinical recommendations. Stage A 55-year-old man presents with a history of recurrent exacerbations of chronic obstructive pulmonary disease (COPD) during the past year. These episodes were characterized by increased shortness of breath, cough, and sputum production. The diagnosis of COPD was made 2 years previously. Pulmonary-function testing then revealed a forced expiratory volume in 1 second (FEV 1 ) of 50% of the predicted value after bronchodilator inhalation, with a ratio of FEV 1 to forced vital capacity (FVC) of 60%. The patient had a 30-pack-year smoking history but stopped smoking after chronic lung disease was diagnosed. On the current visit, he ...

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