Abstract:
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. It is unclear whether prophylactic antibiotics are associated with lower rates of exacerbations in patients with chronic obstructive pulmonary disease (COPD).1 Recent randomized clinical trials (RCTs) have addressed this controversial topic. This JAMA Clinical Evidence Synopsis summarizes a Cochrane review2 of 7 RCTs on prophylactic antibiotic use in COPD.