Short-course Antibiotic Treatment in AECOPD: a Meta-analysis of Double-blind Studies

Short-course Versus Very Short-course Antibiotic Treatment in Acute Exacerbations of COPD: a Meta-analysis of Double-blind Studies

Chronic obstructive pulmonary disease (COPD) is a common disease worldwide and a leading cause of death and disability globally. Given that bacteria are implicated in a substantial proportion of acute exacerbation of COPD (AECOPD), antibiotics are frequently used. However, this current practice may lead to antibiotic overuse further increasing drug resistance and side effects. Although the small literature on interventions to prove the effective of short course of antibiotic, a metaanalysis of published randomised double-blind studies comparing the same antibiotics compared to a previous study is performed to determine whether a short course of antibiotic treatment is as effective as a very short course in patients with an exacerbation of COPD (EACOPD). The authors systematically searched electronic databases on the literature of controlled trials on Medline and Embase with no language, location, or time restrictions. The authors retrieved observational and controlled trials comparing different durations of the same oral antibiotic therapy in the treatment of acute exacerbations of COPD. The authors included 30 randomized, placebo-controlled trials for COPD patients. There was no statistically significant difference between shorter and longer antibiotic courses in early clinical success. In conclusion, Short-course antibiotic treatment is as effective as very short-course treatment in patients with mild to moderate exacerbations of chronic bronchitis and COPD.

Study Overview

• Status: Active, not recruiting
• Conditions: COPD Exacerbation

• Study Type: Observational
• Enrollment (Actual): 2

Contacts and Locations

Study Locations

• Tunisia
  • Monastir, Tunisia, 5000
    • Semir Nouira

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Non-Probability Sample

Study Population

We searched on the literature of controlled trials on Medline and Embase using the following search terms: COPD, antibiotic treatment and clinical trials. We also searched the reference lists of included studies for additional studies.

Description

Inclusion Criteria:

• Studies considered eligible for inclusion were randomised trials of antibiotic intervention involving adult patients >18 years of age with a diagnosis of AECOPD.

Exclusion Criteria:

• Studies not published in the English language or with more than two or different antibiotics were excluded

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Short-course; Group with short treatment of antibiotic of <= 5 days
Very short-course; Group with short treatment of antibiotic of <= 3 days

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical success	clinical cure at early follow-up	30 days

Collaborators and Investigators

• Sponsor: University of Monastir

Study record dates

Study Major Dates

• Study Start (Actual): February 24, 2022
• Primary Completion (Anticipated): March 5, 2023
• Study Completion (Anticipated): May 8, 2023

Study Registration Dates

• First Submitted: May 7, 2022
• First Submitted That Met QC Criteria: May 17, 2022
• First Posted (Actual): May 18, 2022

Study Record Updates

• Last Update Posted (Actual): August 17, 2022
• Last Update Submitted That Met QC Criteria: August 16, 2022
• Last Verified: August 1, 2022

More Information

Terms related to this study

• Keywords: AECOPD; antibiotic treatment; meta analysis; short course; Forest plot
• Other Study ID Numbers: Meta analysis

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No