Effectiveness and Safety of Inhaled Antibiotics in Patients With Chronic Obstructive Pulmonary Disease. A Multicentre Observational Study
We aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment. Multicentre retrospective observati...
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| Vydané v: | Archivos de bronconeumología (English ed.) Ročník 58; číslo 1; s. 11 |
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| Hlavní autori: | , , , , , , , , , , , , , , , , |
| Médium: | Journal Article |
| Jazyk: | English |
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01.01.2022
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| ISSN: | 1579-2129, 1579-2129 |
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| Abstract | We aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment.
Multicentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared.
COPD exacerbations.
side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication.
Of 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV
=43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (-33.3%; P<.001), hospital admissions (-33.3%; P<.001) and hospitalization days (-26.2%; P=.003). We found no difference in effectiveness between patients with or without associated bronchiectasis. Positive patient outcomes were more pronounced in PA-eradicated patients. We found a significant reduction in daily expectoration (-33.1%; P=.024), mucopurulent/purulent sputum (-53.9%; P<.001), isolation of any potentially pathogenic microorganisms (PPM) (-16.7%; P<.001), CBI by any PPM (-37.4%; P<.001) and CBI by PA (-49.8%; P<.001). CBI by any PPM and ≥three previous exacerbations were associated with a better treatment response. 25.4% of patients presented non-severe side-effects, the most frequent of these being bronchospasm (10.5%), dyspnoea (8.8%) and cough (1.7%).
In COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis. |
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| AbstractList | We aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment.
Multicentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared.
COPD exacerbations.
side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication.
Of 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV
=43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (-33.3%; P<.001), hospital admissions (-33.3%; P<.001) and hospitalization days (-26.2%; P=.003). We found no difference in effectiveness between patients with or without associated bronchiectasis. Positive patient outcomes were more pronounced in PA-eradicated patients. We found a significant reduction in daily expectoration (-33.1%; P=.024), mucopurulent/purulent sputum (-53.9%; P<.001), isolation of any potentially pathogenic microorganisms (PPM) (-16.7%; P<.001), CBI by any PPM (-37.4%; P<.001) and CBI by PA (-49.8%; P<.001). CBI by any PPM and ≥three previous exacerbations were associated with a better treatment response. 25.4% of patients presented non-severe side-effects, the most frequent of these being bronchospasm (10.5%), dyspnoea (8.8%) and cough (1.7%).
In COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis. We aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment.BACKGROUNDWe aimed to describe the effectiveness and safety of inhaled antibiotics in chronic obstructive pulmonary disease (COPD) patients, as well as the patient profile in which they are usually prescribed and the patient groups that can most benefit from this treatment.Multicentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared.METHODSMulticentre retrospective observational cohort study in COPD patients who had received ≥1 dose of inhaled antibiotics in the last 5 years. Clinical data from the two years prior to and subsequent to the start of the treatment were compared.COPD exacerbations.PRIMARY OUTCOMECOPD exacerbations.side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication.SECONDARY OUTCOMESside effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication.Of 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV1=43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (-33.3%; P<.001), hospital admissions (-33.3%; P<.001) and hospitalization days (-26.2%; P=.003). We found no difference in effectiveness between patients with or without associated bronchiectasis. Positive patient outcomes were more pronounced in PA-eradicated patients. We found a significant reduction in daily expectoration (-33.1%; P=.024), mucopurulent/purulent sputum (-53.9%; P<.001), isolation of any potentially pathogenic microorganisms (PPM) (-16.7%; P<.001), CBI by any PPM (-37.4%; P<.001) and CBI by PA (-49.8%; P<.001). CBI by any PPM and ≥three previous exacerbations were associated with a better treatment response. 25.4% of patients presented non-severe side-effects, the most frequent of these being bronchospasm (10.5%), dyspnoea (8.8%) and cough (1.7%).RESULTSOf 693 COPD patients analyzed (aged 74.1; 86.3% men; mean FEV1=43.7%), 71.7% had bronchiectasis and 46.6% presented chronic bronchial infection (CBI) by Pseudomonas aeruginosa (PA). After 1 year of treatment with inhaled antibiotics, there was a significant decrease in the number of exacerbations (-33.3%; P<.001), hospital admissions (-33.3%; P<.001) and hospitalization days (-26.2%; P=.003). We found no difference in effectiveness between patients with or without associated bronchiectasis. Positive patient outcomes were more pronounced in PA-eradicated patients. We found a significant reduction in daily expectoration (-33.1%; P=.024), mucopurulent/purulent sputum (-53.9%; P<.001), isolation of any potentially pathogenic microorganisms (PPM) (-16.7%; P<.001), CBI by any PPM (-37.4%; P<.001) and CBI by PA (-49.8%; P<.001). CBI by any PPM and ≥three previous exacerbations were associated with a better treatment response. 25.4% of patients presented non-severe side-effects, the most frequent of these being bronchospasm (10.5%), dyspnoea (8.8%) and cough (1.7%).In COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis.CONCLUSIONSIn COPD patients with multiple exacerbations and/or CBI by any PPM (especially PA), inhaled antibiotics appear to be an effective and safe treatment, regardless of the presence of bronchiectasis. |
| Author | Barreiro, Esther Costa Sola, Roser Rodríguez Pons, Laura Tabernero Huguet, Eva Sánchez-Cuéllar, Silvia De la Rosa Carrillo, David Blanco Aparicio, Marina Rodríguez Hermosa, Juan Luís Celorrio Jiménez, Nuria Almadana Pacheco, Virginia García-Clemente, Marta María Golpe, Rafael Martínez-García, Miguel Ángel Torres Arroyo, Irene Miravitlles, Marc Calero Acuña, Carmen Dacal Quintas, Raquel |
| Author_xml | – sequence: 1 givenname: David surname: De la Rosa Carrillo fullname: De la Rosa Carrillo, David email: david.rosa23@gmail.com organization: Pneumology Service, Hospital de la Santa Creu i Sant Pau, C. Sant Quintí 89, 08041, Barcelona, Spain. Electronic address: david.rosa23@gmail.com – sequence: 2 givenname: Miguel Ángel surname: Martínez-García fullname: Martínez-García, Miguel Ángel organization: Pneumology Service, Hospital Universitario y Politécnico La Fe, Av. de Fernando Abril Martorell 106, 46026, Valencia, Spain – sequence: 3 givenname: Esther surname: Barreiro fullname: Barreiro, Esther organization: Pulmonology Department, Hospital del MAR-IMIM, CEXS (UPF), CIBERES, Passeig Marítim de la Barceloneta 25-29, 08003, Barcelona, Spain – sequence: 4 givenname: Eva surname: Tabernero Huguet fullname: Tabernero Huguet, Eva organization: Pneumology Service, Hospital de Cruces, Cruces Plaza, s/n, 48903, Barakaldo, Bizkaia, Spain – sequence: 5 givenname: Roser surname: Costa Sola fullname: Costa Sola, Roser organization: Pneumology Service, Hospital Mutua de Terrassa, Plaça del Doctor Robert 5, 08221, Terrassa, Barcelona, Spain – sequence: 6 givenname: Marta María surname: García-Clemente fullname: García-Clemente, Marta María organization: Pneumology Service, Hospital Universitario Central de Asturias, Av. Roma, s/n, 33011, Oviedo, Spain – sequence: 7 givenname: Nuria surname: Celorrio Jiménez fullname: Celorrio Jiménez, Nuria organization: Pneumology Service, Hospital de Viladecans, Av. de Gavà 38, 08840, Viladecans, Barcelona, Spain – sequence: 8 givenname: Laura surname: Rodríguez Pons fullname: Rodríguez Pons, Laura organization: Pneumology Service, Hospital Universitario Germans Trias i Pujol, Carretera de Canyet, s/n, 08916, Badalona, Barcelona, Spain – sequence: 9 givenname: Carmen surname: Calero Acuña fullname: Calero Acuña, Carmen organization: Pneumology Service, Hospital Universitario Virgen del Rocio, Av. Manuel Siurot, s/n, 41013, Sevilla, Spain – sequence: 10 givenname: Juan Luís surname: Rodríguez Hermosa fullname: Rodríguez Hermosa, Juan Luís organization: Pneumology Service, Hospital Clínico San Carlos, School of Medicine, Universidad Complutense de Madrid, Calle del Profesor Martín Lagos, s/n, 28040, Madrid, Spain – sequence: 11 givenname: Rafael surname: Golpe fullname: Golpe, Rafael organization: Pneumology Service, Hospital Universitario Lucus Augusti, Rúa Dr. Ulises Romero 1, 27003, Lugo, Spain – sequence: 12 givenname: Raquel surname: Dacal Quintas fullname: Dacal Quintas, Raquel organization: Pneumology Service, Complexo Hospitalario Universitario de Ourense, Calle Ramon Puga Noguerol 54, 32005, Ourense, Spain – sequence: 13 givenname: Silvia surname: Sánchez-Cuéllar fullname: Sánchez-Cuéllar, Silvia organization: Pneumology Service, Hospital Universitario Infanta Leonor, Av. Gran Vía del Este 80, 28031, Madrid, Spain – sequence: 14 givenname: Irene surname: Torres Arroyo fullname: Torres Arroyo, Irene organization: Pneumology Service, Hospital Fundación Alcorcón, Calle Budapest 1, 28922, Alcorcón, Madrid, Spain – sequence: 15 givenname: Marina surname: Blanco Aparicio fullname: Blanco Aparicio, Marina organization: Pneumology Service, Complexo Hospitalario Universitario A Coruña, Xubias de Arriba 84, 15006, A Coruña, Spain – sequence: 16 givenname: Virginia surname: Almadana Pacheco fullname: Almadana Pacheco, Virginia organization: Pneumology Service, Hospital Universitario Virgen de la Macarena, Calle Dr. Fedriani 3, 41009, Sevilla, Spain – sequence: 17 givenname: Marc surname: Miravitlles fullname: Miravitlles, Marc organization: Pneumology Service, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorios (CIBERES), Passeig de la Vall d'Hebron 119, 08035, Barcelona, Spain |
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| Copyright | Copyright © 2021 SEPAR. Publicado por Elsevier España, S.L.U. All rights reserved. |
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| Keywords | Chronic bronchial infection Exacerbaciones Infección bronquial crónica Exacerbations Pseudomonas aeruginosa Bronchiectasis Chronic obstructive pulmonary disease Antibióticos inhalados Enfermedad pulmonar obstructiva crónica Inhaled antibiotics Bronquiectasia |
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| Title | Effectiveness and Safety of Inhaled Antibiotics in Patients With Chronic Obstructive Pulmonary Disease. A Multicentre Observational Study |
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