Among patients hospitalised for acute exacerbations of chronic obstructive pulmonary disease (COPD), those who received antibiotics in the first two hospital days had improved outcomes, according to a new American study.
In the study, doctors examined the association between the use of antibiotics and outcomes among patients hospitalised for acute exacerbations of COPD at 413 acute care facilities throughout the United States, between January 2006 and December 2007.
The primary outcomes analysed included a composite measure of treatment failure, defined as the initiation of mechanical ventilation after the second hospital day, inpatient mortality, or readmission for acute exacerbations of COPD within 30 days of discharge; length of stay, and hospital costs.
Of 84,621 patients, 79 per cent received at least two consecutive days of antibiotic treatment.
The researchers found that compared with patients not receiving antibiotics in the first two days, antibiotic-treated patients were less likely to receive mechanical ventilation after the second hospital day, had lower inpatient mortality, a lower incidence of treatment failure, and lower rates of readmission for acute exacerbations of COPD. Patients treated with and without antibiotics had similar lengths of stay, but patients treated with antibiotics had lower costs.
Patients treated with antibiotic agents had a higher rate of readmissions for the bacterial infection Clostridium difficile than those who were not treated.
JAMA 2010;303:2035-2042
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