Chest
Original ResearchCopdComparison of First-Line With Second-Line Antibiotics for Acute Exacerbations of Chronic Bronchitis: A Metaanalysis of Randomized Controlled Trials
Section snippets
Literature Search
To identify the randomized controlled trials (RCTs) that were appropriate for inclusion in the metaanalysis, we conducted a systematic search of the PubMed and the Cochrane Central Register of Controlled Trials. We used the following search terms: “acute exacerbations”; “COPD”; and “chronic bronchitis” combined with “amoxicillin,” “clavulanic acid,” “ampicillin,” “sulfamethoxazole,” “trimethoprim”, “doxycycline,” “quinolones,” “macrolides,” “Haemophilus influenzae,” “Moraxella catarrhalis,” and
Selected Studies
This metaanalysis was performed in accordance with the QUOROM statement.18Figure 1 displays the process of identifying the relevant articles. Of the 177 articles that were initially retrieved, 80 were excluded due to reasons presented in Figure 1. In addition, 35 RCTs were omitted because they regarded the comparison of antibiotics that are not commonly used today or were withdrawn from the market for the treatment of AECBs. Also, 25 RCTs were excluded because they compared first-line
Discussion
The results of this metaanalysis suggest that the administration of first-line antimicrobial agents to CE patients with AECBs was associated with lower treatment success compared to the administration of second-line agents. However, no differences were found among the compared regimens with regard to mortality, microbiological outcomes (ie, treatment success in ME patients and pathogen eradication of most common pathogens in patients with AECBs), and safety (ie, drug-related adverse effects in
References (34)
- et al.
Pharmacoeconomic evaluation of acute exacerbations of chronic bronchitis and COPD
Chest
(2002) - et al.
Treatment cost of acute exacerbations of chronic bronchitis
Clin Ther
(1999) - et al.
Relationship between bacterial flora in sputum and functional impairment in patients with acute exacerbations of COPD
Chest
(1999) - et al.
Does quality of reports of randomised trials affect estimates of intervention efficacy reported in meta-analyses?
Lancet
(1998) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Improving the quality of reports of meta-analyses of randomized controlled trials: the QUOROM statement
Lancet
(1999) Efficacy of fleroxacin versus amoxicillin in acute exacerbations of chronic bronchitis
Am J Med
(1993)Fleroxacin versus amoxicillin in the treatment of acute exacerbation of chronic bronchitis
Am J Med
(1993)- et al.
A double-blind comparison of the effects of cefaclor and amoxycillin on respiratory tract and oropharyngeal flora and clinical response in acute exacerbations of bronchitis
Respir Med
(1991) - et al.
Short-term and long-term outcomes of moxifloxacin compared to standard antibiotic treatment in acute exacerbations of chronic bronchitis
Chest
(2004)
New strains of bacteria and exacerbations of chronic obstructive pulmonary disease
N Engl J Med
Relationship between bacterial colonization and the frequency, character, and severity of COPD exacerbations
Thorax
Appropriate outpatient treatment of acute bacterial exacerbations of chronic bronchitis
Am J Med
Treating acute exacerbations of chronic bronchitis in the face of antibiotic resistance
Cleve Clin J Med
Treatment of acute exacerbations of chronic bronchitis: antibiotic therapy
Semin Respir Crit Care Med
Canadian guidelines for the management of acute exacerbations of chronic bronchitis
Can Respir J
Moxifloxacin for the treatment of acute exacerbations of chronic obstructive pulmonary disease
Clin Infect Dis
Cited by (51)
Acute Exacerbations of Chronic Obstructive Pulmonary Disease
2014, Mandell, Douglas, and Bennett's Principles and Practice of Infectious DiseasesGuidelines for the management of adult lower respiratory tract infections - Summary
2011, Clinical Microbiology and InfectionManagement of COPD exacerbations
2010, American Family PhysicianMacrolide Use in Chronic Obstructive Pulmonary Disease
2024, Progress in Inflammation ResearchA Review of Antibiotic Consumptions at Moewardi Municipality Hospital Dental Ward Surakarta, Indonesia Using Algorithm Gyssens
2022, Journal of Medicinal and Chemical Sciences
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.