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Abstract: Background 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. Methods 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. Primary outcome: COPD exacerbations. Secondary outcomes: side effects, symptomatology (sputum purulence, dyspnoea), microbiological profile and pathogen eradication. Results 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%). Conclusions 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.
Fuente: Archivos de Bronconeumología, 2022, 58, 11-21
Editorial: Elsevier Doyma
Año de publicación: 2022
Nº de páginas: 11
Tipo de publicación: Artículo de Revista
DOI: 10.1016/j.arbres.2021.03.009
ISSN: 0300-2896,1579-2129
Url de la publicación: https://doi.org/10.1016/j.arbres.2021.03.009
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ROSA CARRILLO, DAVID DE LA
MARTÍNEZ-GARCÍA, MIGUEL ÁNGEL
BARREIRO, ESTHER
TABERNERO HUGUET, EVA
COSTA SOLA, ROSER
GARCÍA-CLEMENTE, MARTA MARÍA
CELORRIO JIMÉNEZ, NURIA
RODRÍGUEZ PONS, LAURA
CALERO ACUÑA, CARMEN
RODRÍGUEZ HERMOSA, JUAN LUIS
GOLPE, RAFAEL
DACAL QUINTAS, RAQUEL
SÁNCHEZ-CUÉLLAR, SILVIA
TORRES ARROYO, IRENE
BLANCO APARICIO, MARINA
ALMADANA PACHECO, VIRGINIA
MIRAVITLLES, MARCA
CARLOS ANTONIO AMADO DIAGO
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