WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Monday, June 27, 2022

ATBs in COPD

REBEL EM - June 27, 2022 - By Anand Swaminathan
Clinical Question: Is a 2-day course of levofloxacin non-inferior to a 7-day course for clinical cure in patients with a COPD exacerbation?
Authors Conclusions: “Levofloxacin once daily for 2 days is not inferior to 7 days with respect to cure rate, need for additional antibiotics and hospital readmission in AECOPD. Our findings would improve patient compliance and reduce the incidence of bacterial resistance and adverse effects.”
Our Conclusions: We agree that this study demonstrates non-inferiority of a 2-day course of levofloxacin to a 7-day course. However, the trial has a number of issues including the subjectivity of the outcome measure which may bias the results. Subsequent studies should focus on generating high-quality data looking at short-course antibiotics versus no antibiotics.
Bottom Line: It remains unclear if mild to moderate AECOPD benefit from antibiotics but, if you are going to prescribe them, a short course appears to be adequate.