{"title":"Does routinely prescribing antibiotics at exacerbation of COPD reduce the likelihood of further exacerbations?","authors":"","doi":"10.1016/j.rmedu.2009.02.005","DOIUrl":"https://doi.org/10.1016/j.rmedu.2009.02.005","url":null,"abstract":"","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"5 1","pages":"Page 27"},"PeriodicalIF":0.0,"publicationDate":"2009-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2009.02.005","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137256876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Salmeterol with fluticasone and tiotropium is better at improving lung function in moderate to severe COPD than any one or two elements of the combination","authors":"","doi":"10.1016/j.rmedu.2008.08.008","DOIUrl":"https://doi.org/10.1016/j.rmedu.2008.08.008","url":null,"abstract":"","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"4 4","pages":"Page 134"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2008.08.008","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91724092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Are shorter courses of antibiotics adequate in exacerbations of COPD?","authors":"","doi":"10.1016/j.rmedu.2008.08.014","DOIUrl":"https://doi.org/10.1016/j.rmedu.2008.08.014","url":null,"abstract":"<div><h3>Background</h3><p>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).</p></div><div><h3>Methods</h3><p>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.</p></div><div><h3>Results</h3><p>Twenty-one 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 0.90–1.08). At late follow-up the summary OR was 1.0 (95% CI 0.91–1.10) and the summary OR for bacteriological cure was 1.05 (95% CI 0.87–1.26). 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.</p></div><div><h3>Conclusions</h3><p>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.</p><p>Reproduced with permission from the BMJ Publishing Group.</p></div>","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"4 4","pages":"Page 140"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2008.08.014","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90015197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A new prognostic index for health outcomes in COPD","authors":"","doi":"10.1016/j.rmedu.2008.08.011","DOIUrl":"https://doi.org/10.1016/j.rmedu.2008.08.011","url":null,"abstract":"<div><h3>Background</h3><p>Chronic obstructive pulmonary disease (COPD) is a debilitating and progressive disease. The severity of the condition has typically been characterized by a single physiological measurement: forced expiratory volume in 1<!--> <!-->second, which has been shown to be prognostic for mortality.</p></div><div><h3>Methods</h3><p>To develop a prognostic tool for COPD that is sensitive not only to mortality but also to other important drivers of health status and cost, data were obtained from a pooled analysis of 12 randomized controlled trials and 3 main outcomes were chosen: mortality, hospitalization, and number of exacerbations. Cox models were employed for the time-to-event data (death or hospitalization), and a negative binomial model was used for calculating the count data (exacerbations). From these models, 3 specific indexes were developed on a 100-point scale, and 1 composite index was obtained as a mean of the specific indexes. One-third of the data was reserved for validation purposes.</p></div><div><h3>Results</h3><p>All indexes provided good discrimination among tertiles in the training and validation samples. The composite index had a performance very similar to that of the specific index in both the training and validation samples: the overall C statistic was estimated as 0.71 for both mortality and hospitalization. Each 10-point change in the composite index corresponds to an increase of 54% in the hazard ratio of death, 57% in the hazard ratio of hospitalization, and 21% in the incidence rate of exacerbations.</p></div><div><h3>Conclusions</h3><p>A composite index for COPD prognosis (the COPD Prognostic Index) has been validated in data not used in its development and is capable of predicting not only mortality, but also hospitalizations and exacerbations. All factors included in the index are straightforward to obtain, which should make the index suitable for use in primary as well as secondary care settings.<br>Reproduced with permission from the American Medical Association</p></div>","PeriodicalId":101083,"journal":{"name":"Respiratory Medicine: COPD Update","volume":"4 4","pages":"Pages 136-137"},"PeriodicalIF":0.0,"publicationDate":"2008-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.rmedu.2008.08.011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137086983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}