Antibiotics for COPD exacerbations: does drug or duration matter? A primary care database analysis.

Antibiotics for COPD exacerbations: does drug or duration matter? A primary care database analysis. BMJ Open Respir Res. 2019;6(1):e000458 Authors: Stolbrink M, Bonnett LJ, Blakey JD Abstract Introduction: Antibiotics are routinely given to people with chronic obstructive pulmonary disease (COPD) presenting with lower respiratory tract infection (LRTI) symptoms in primary care. Population prescribing habits and their consequences have not been well-described. Methods: We conducted a retrospective analysis of antibiotic prescriptions for non-pneumonic exacerbations of COPD from 2010 to 2015 using the UK primary care Optimum Patient Care Research Database. As a proxy of initial treatment failure, second antibiotic prescriptions for LRTI or all indications within 14 days were the primary and secondary outcomes, respectively. We derived a model for repeat courses using univariable and multivariable logistic regression analysis. Results: A total of 8.4% of the 9042 incident events received further antibiotics for LRTI, 15.5% further courses for any indication. Amoxicillin and doxycycline were the most common index and second-line drugs, respectively (58.7% and 28.7%), mostly given for 7 days. Index drugs other than amoxicillin, cardiovascular disease, pneumococcal vaccination and more primary care consultations were statistically significantly associated with repeat prescriptions for LRTI (p
Source: Respiratory Care - Category: Respiratory Medicine Authors: Tags: BMJ Open Respir Res Source Type: research

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Objective: to evaluate the effect of conjugated pneumococcal vaccine Prevenar 13 on the course of COPD in combination with type 2 diabetes.The study included 76 patients with COPD III (40.8%) and COPD IV (59.2%) in combination with type 2 diabetes, 72 (94.7%) men and 4 (5.3%) women, averaga age 64.72 years. All patients were current or past smokers, the smoking index- 45.11. The duration of COPD was 8.71 years, the lasting of diabetes mellitus was 10.23 years. All patients were overweight, BMI=31.67 kg/m2. ±Before vaccination, patients reported severe clinical symptoms (CAT=27.99±3.79, CI 95% 19-36) and parti...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
One of the extremely important problems of managing patients with COPD is to prevent exacerbations. It becomes particularly relevant in the run-up to or during a flu epidemic.Objective: To assess the clinical and economic efficacy of joint vaccine prophylaxis with conjugated pneumococcal vaccine (PCV13) and influenzal vaccine in patients with COPD.Material and methods: The study included 153 patients. They divided into three groups of observation. The 1 group (n = 53) - of patients vaccinated with PCV13. The 2 group (n=51) vaccinated with PCV13 and influenzal vaccine simultaneously or with an interval of not more than 2 we...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Airway pharmacology and treatment Source Type: research
Conclusion: The mean age of patients was high, low schooling, and no correct use of therapy. It requires continued education to improve care delivery and adherence to treatment.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Nurses Source Type: research
Conclusions: In this year follow up, PV had already a beneficial impact in decreasing the severity of RI in CRP.Reference:1. Martins RN, Vaz LR. Influenza and Pneumococcal Vaccination in Chronic Respiratory Patients-Are We in the Right Path?. Arch bronconeumol. 2019 Jan
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research
Background: Antibiotics are routinely given to COPD patients presenting with lower respiratory tract infection (LRTI) symptoms in primary care. Yet the optimal drug and duration for effective first line treatment is unclear.Aim: To characterise antibiotic prescriptions for LRTI in COPD patients and investigate factors associated with repeat prescriptions.Methods: A retrospective analysis of antibiotic prescriptions for non-pneumonic LRTI in COPD patients from 2010 to 2015 using the UK primary care Optimum Patient Care Research Database. Second antibiotic prescriptions for LRTI or all indications within 14 days were the pri...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Monitoring airway disease Source Type: research
Authors: Agrawal R, Moghtader S, Ayyala U, Bandi V, Sharafkhaneh A Abstract Chronic obstructive pulmonary disease (COPD) is a major chronic debilitating condition with significant impact on quality of life, symptoms, comorbidity, health care utilization and longevity. The main pathophysiological hallmark of COPD is expiratory flow limitation which impairs the ability of respiratory system to adequately and properly ventilate. To be able to prognosticate and manage patients with COPD, various societies have developed classifications of disease severity. Current classification schemes combine three elements that incl...
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
ConclusionAdults who received pneumococcal vaccines experienced reduced rates of hospital versus ICU admissions due to pneumonia infection.
Source: Journal of Pharmaceutical Health Services Research - Category: Drugs & Pharmacology Authors: Tags: Research Paper Source Type: research
Conclusions: Further, adequately powered, high quality studies are needed. It is crucial for individual institutions to monitor their own vaccination rates to determine if there is scope for performance improvement. PMID: 31208087 [PubMed - in process]
Source: Medicina (Kaunas) - Category: Universities & Medical Training Authors: Tags: Medicina (Kaunas) Source Type: research
CONCLUSIONS: After implementation of a pneumococcal conjugate vaccination program in US children, and despite the herd protection observed in US adults, a persistent burden of PCV13-type CAP remains in this population. PMID: 31072732 [PubMed - as supplied by publisher]
Source: Vaccine - Category: Allergy & Immunology Authors: Tags: Vaccine Source Type: research
Parvaiz A Koul, Sudhir Chaudhari, Ramesh Chokhani, D Christopher, Raja Dhar, Kumar Doshi, A Ghoshal, SK Luhadiya, Ashok Mahashur, Ravindra Mehta, Amita Nene, Md Rahman, Rajesh SwarnakarLung India 2019 36(3):216-225 Globally, pneumococcal diseases are a significant public health concern. They are preventable and frequently occur among older adults. Major risk factors for the disease are extremes of age, alcohol intake, smoking, air pollution, and comorbid conditions (diabetes, chronic obstructive pulmonary disease, chronic kidney disease, liver disease, and heart disease). Risk factors, coupled with limited disease-burden ...
Source: Lung India - Category: Respiratory Medicine Authors: Source Type: research
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