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.