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Prophylactic antibiotic therapy for chronic bronchitis

Overview of attention for article published in Cochrane database of systematic reviews, January 2003
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Title
Prophylactic antibiotic therapy for chronic bronchitis
Published in
Cochrane database of systematic reviews, January 2003
DOI 10.1002/14651858.cd004105
Pubmed ID
Authors

Staykova, T, Black, P N, Chacko, E E, Poole, P, Staykova, Toni, Black, Peter N, Chacko, Emme E, Poole, Phillippa

Abstract

The use of prophylactic antibiotics to reduce the frequency and severity of acute exacerbations of chronic bronchitis is controversial. To determine if prophylactic antibiotics reduce the frequency of exacerbations and/or days of disability in subjects with chronic bronchitis. We searched the Cochrane Airways Group Register of Clinical Trials and the bibliographies of relevant articles. Randomised controlled trials of prophylactic antibiotics in patients with chronic bronchitis and/or COPD were selected. The eligibility of studies for inclusion was evaluated by three independent reviewers. Nine trials involving 1055 subjects were included in the analysis. All were performed before 1970. Concealment of allocation was assessed as clearly adequate in only 3 studies. The likelihood of having a exacerbation at any time during the course of the study was decreased with treatment (Relative Risk 0.91, 95% Confidence Intervals (CI) 0.84, 0.99). There was a small reduction in the number of exacerbations per patient per year with prophylactic antibiotics but this was not statistically significant ( Weighted Mean Difference (WMD) -0.15, 95%CI -0.34, 0.04 ). There was a modest but significant reduction of 22% in the number of days of disability per patient per month treated ( WMD -0.95, 95%CI -1.89 to - 0.01 ). A parallel reduction in the days of disability for each exacerbation (WMD -2.08, 95% CI -4.08 to -0.07) was seen. There was a small increase in adverse effects with antibiotics. Prophylactic antibiotics in chronic bronchitis / COPD have a small but statistically significant effect in reducing the days of illness due to exacerbations of chronic bronchitis. They do not have a place in routine treatment because of concerns about the development of antibiotic resistance and the possibility of adverse effects. The available data are over 30 years old, so the pattern of antibiotic sensitivity may have changed and there is a wider range of antibiotics in use.

Mendeley readers

The data shown below were compiled from readership statistics for 5 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 5 100%

Demographic breakdown

Readers by professional status Count As %
Student > Master 2 40%
Lecturer 1 20%
Researcher 1 20%
Unspecified 1 20%
Readers by discipline Count As %
Medicine and Dentistry 4 80%
Unspecified 1 20%