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JAMA Clinical Evidence Synopsis |

Prophylactic Antibiotic Therapy in Chronic Obstructive Pulmonary Disease

Samantha C. Herath, MBBS, MPhil, FRACP1; Phillippa Poole, BSc, MBChB, MD, FRACP2
[+] Author Affiliations
1Day Unit, Department of Respiratory Medicine, Montreal Chest Institute, Montreal, Quebec, Canada
2Department of Medicine, The University of Auckland, Auckland, New Zealand
JAMA. 2014;311(21):2225-2226. doi:10.1001/jama.2014.4929.
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Clinical Question  Is prophylactic antibiotic treatment associated with fewer exacerbations or improved health-related quality of life (HRQOL) in patients with chronic obstructive pulmonary disease (COPD)?

Bottom Line  Continuous macrolide antibiotic use for prophylaxis was associated with a clinically significant reduction in COPD exacerbations. Pulsed antibiotic use was not associated with benefit. Continuous and pulsed antibiotics were associated with improved HRQOL, but this was not clinically significant.

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Figure.
Association of Prophylactic Antibiotic Therapy With the Incidence of Chronic Obstructive Pulmonary Disease Exacerbations

Source: Data have been adapted with permission from Wiley.2 The size of the data markers indicate the weight of the study. The odds ratio was calculated using a random-effect model.

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