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Int. J. Mol. Sci. 2017, 18(7), 1344; doi:10.3390/ijms18071344

Chronic Respiratory Infection in Patients with Chronic Obstructive Pulmonary Disease: What Is the Role of Antibiotics?

1
Pneumology Department, Hospital Universitari Vall d’Hebron, Ciber de Enfermedades Respiratorias (CIBERES), 08035 Barcelona, Spain
2
Department of Medicine, Division of Pulmonary Diseases/Critical Care Medicine, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA
3
Pulmonary Section, The South Texas Veterans Health Care System, Audie L. Murphy Memorial Veterans Hospital Division, Pulmonary Diseases Section (111E), 7400 Merton Minter Boulevard, San Antonio, TX 78229, USA
*
Author to whom correspondence should be addressed.
Academic Editor: Francesco B. Blasi
Received: 31 March 2017 / Revised: 24 May 2017 / Accepted: 3 June 2017 / Published: 23 June 2017
(This article belongs to the Special Issue Lung Diseases: Chronic Respiratory Infections)
View Full-Text   |   Download PDF [240 KB, uploaded 23 June 2017]

Abstract

Chronic infections are associated with exacerbation in patients with chronic obstructive pulmonary disease (COPD). The major objective of the management of these patients is the prevention and effective treatment of exacerbations. Patients that have increased sputum production, associated with purulence and worsening shortness of breath, are the ones that will benefit from antibiotic therapy. It is important to give the appropriate antibiotic therapy to prevent treatment failure, relapse, and the emergence of resistant pathogens. In some patients, systemic corticosteroids are also indicated to improve symptoms. In order to identify which patients are more likely to benefit from these therapies, clinical guidelines recommend stratifying patients based on their risk factor associated with poor outcome or recurrence. It has been identified that patients with more severe disease, recurrent infection and presence of purulent sputum are the ones that will be more likely to benefit from this therapy. Another approach related to disease prevention could be the use of prophylactic antibiotics during steady state condition. Some studies have evaluated the continuous or the intermittent use of antibiotics in order to prevent exacerbations. Due to increased bacterial resistance to antibiotics and the presence of side effects, several antibiotics have been developed to be nebulized for both treatment and prevention of acute exacerbations. There is a need to design long-term studies to evaluate these interventions in the natural history of the disease. The purpose of this publication is to review our understanding of the role of bacterial infection in patients with COPD exacerbation, the role of antibiotics, and future interventions. View Full-Text
Keywords: chronic respiratory infections in COPD; exacerbations of chronic obstructive pulmonary disease; antibiotics; bacteria; prevention; colonization chronic respiratory infections in COPD; exacerbations of chronic obstructive pulmonary disease; antibiotics; bacteria; prevention; colonization
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Miravitlles, M.; Anzueto, A. Chronic Respiratory Infection in Patients with Chronic Obstructive Pulmonary Disease: What Is the Role of Antibiotics? Int. J. Mol. Sci. 2017, 18, 1344.

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