Concise summaries and expert physician commentary that busy clinicians need to enhance patient care.The most effective and engaging way for clinicians to learn, improve their practice, and prepare for board exams.NEW! Der längere Zeitraum bis zur nächsten Exazerbation wird mit erheblichen UAW erkauft.
Eine Intensivierung der medikamentösen Therapie mit Steroiden und/oder Antibiotika war bei 47 versus 60 % der Patienten erforderlich (Hazard Ratio 0,70; 0,51-0,97). Darauf deuten die Frühere Studien hatten gezeigt, dass eine Langzeitantibiose mit Makroliden wie Azithromycin COPD-Patienten vor weiteren Exazerbationen schützen kann.
Sep 1, 2020 Azithromycin bei COPD Antibiotikum kann vor Exazerbationen schützen Exazerbationen bei COPD-Patienten mindern die Lebensqualität der Betroffenen massiv und bergen ein hohes Mortalitätsrisiko.
Cultures from 68% of the participants in the azithromycin group and 70% in the placebo group who were not colonized with selected respiratory pathogens at the time of enrollment but who became colonized during the course of the study were available for susceptibility testing (P=0.76), and the incidence of resistance to macrolides was 81% and 41% in the two groups, respectively (P<0.001) (Section G in the Among subjects at increased risk for acute exacerbations of COPD who received azithromycin, at a dose of 250 mg once daily, for 1 year in addition to their usual care, the frequency of acute exacerbations was decreased. Wegen des Potenzials einer Antibiotikaresistenz und der Möglichkeit proarrhythmischer Wirkungen rät Vermeersch zu einer vorsichtigen Auswahl der Patienten. Written informed consent was obtained from all participants.The study was approved by the institutional review board at each participating institution. 1.2.46 Consider azithromycin (usually 250 mg 3 times a week) for people with COPD if they: do not smoke and have optimised non-pharmacological management and inhaled therapies, relevant vaccinations and (if appropriate) have been referred for pulmonary rehabilitation and The complete Eligible participants were at least 40 years of age, had a clinical diagnosis of COPD (defined as having a smoking history of at least 10 pack-years, a ratio of postbronchodilator forced expiratory volume in 1 second [FEVExclusion criteria were asthma, a resting heart rate greater than 100 beats per minute, a prolonged corrected QT (QTc) interval (>450 msec), the use of medications that prolong the QTc interval or are associated with torsades de pointes (with the exception of amiodarone),The primary outcome was the time to the first acute exacerbation of COPD, with acute exacerbation of COPD defined as “a complex of respiratory symptoms (increased or new onset) of more than one of the following: cough, sputum, wheezing, dyspnea, or chest tightness with a duration of at least 3 days requiring treatment with antibiotics or systemic steroids.”Secondary outcomes included quality of life, nasopharyngeal colonization with selected respiratory pathogens (i.e., We estimated that with enrollment of 1130 subjects, the study would have 90% power to show a significant difference between the two groups in the time to the first acute exacerbation of COPD, assuming that 50% of the participants in the control groupThe groups were compared with the use of an intention-to-treat survival analysis.
Mit der Registrierung in Mein-DÄ profitieren Sie von folgenden Vorteilen:Um Artikel, Nachrichten oder Blogs kommentieren zu können, müssen Sie (Funded by the National Institutes of Health; ClinicalTrials.gov number, Acute exacerbations of chronic obstructive pulmonary disease (COPD) result in frequent visits to physicians' offices and emergency rooms and numerous hospitalizations and days lost from work; they also account for a substantial percentage of the cost of treating COPD.We used a prospective, parallel-group, placebo-controlled design. Participants were recruited from 17 sites associated with 12 academic health centers in the United States.
In den Sputumuntersuchungen wurden keine wesentlichen Veränderungen in der bakteriellen Besiedlung gefunden. Given the deleterious effects of acute exacerbations of COPD with respect to the risk of death, quality of life, loss of lung function, and cost of care, adding azithromycin to the treatment regimen of patients who have had an acute exacerbation of COPD within the previous year or who require supplemental oxygen is a valuable option; however, the patients should be screened for the presence of QTc prolongation and the risk of QTc prolongation and their hearing should be monitored. Bestellen Sie den kostenfreien Newsletter des Deutschen Ärzteblattes.Immer auf dem Laufenden sein ohne Informationen hinterher zu rennen: