VCU medical team recommends preventive antibiotic for COPD sufferers
Patients suffering from the chronic lung condition COPD, which is the third-leading cause of death and disability in the United States, may benefit greatly from a three-times-a-week dose of an antibiotic, according to a study by Virginia Commonwealth University physicians published in today's issue of the New England Journal of Medicine.
Approximately 24 million Americans suffer from COPD, or chronic obstructive pulmonary disease, which creates recurrent, acute episodes of severe shortness of breath, cough and sputum production. Every episode can threaten the lives of the patients and lead to additional lung function decline.
The VCU team, led by Richard P. Wenzel, M.D., professor and former chair of the VCU Department of Internal Medicine in the VCU School of Medicine, and former president of the International Society for Infectious Diseases, performed a critical review of current clinical studies, reviewed the pharmacology and adverse effects of the antibiotic, azithromycin, and examined the risks and benefits of a regimen of a Monday, Wednesday and Friday dose of azithromycin.
Wenzel and colleagues Alpha A. Fowler III, M.D., professor and chair of the Division of Pulmonary Disease and Critical Care Medicine, and Michael B. Edmond, M.D., M.P.H., professor and chair of the Division of Infectious Diseases, concluded that a large segment of COPD sufferers could benefit from the preventive approach.
According to Wenzel, the proposed approach for use of azithromycin for the prevention of COPD exacerbations has not been endorsed by any of the large pulmonary and infectious disease organizations, including the GOLD group. But he said that the current review is compelling enough that these groups may move to revisit their current guidelines.
"This approach has the potential to eliminate one-third of the severe exacerbations each year among patients with COPD," said Wenzel.
However, according to Wenzel, this protocol may not be suitable for every patient. Some may suffer adverse consequences with a year-long use of azithromycin, such as hearing loss, antibiotic resistance and heart rhythm disturbances. The VCU team reviewed many of the studies of the drug and made recommendations to minimize the unwanted consequences yet provide relief to a large segment of the COPD patients.
In the study, the authors have outlined a list of proposed criteria for choosing which patients would benefit and who should not take the proposed regimen. They would exclude those with a high risk of cardiovascular disease who may be prone to dangerous cardiac rhythm disturbances; those on drugs already known to affect the electrocardiogram adversely and that might interact with the antibiotic azithromycin; and those with hearing loss.
Wenzel and his colleagues noted that an earlier study based on a large clinical trial indicated that if approximately three people must be treated to prevent one annual exacerbation, then the cost to prevent an exacerbation would be $3,564 for daily dosing, or $1,545 for dosing three times a week.
They also noted that a recent study in Canada showed that the cost of a hospital stay following an acute exacerbation of COPD was $9,557 Canadian dollars. In 2000, 726,000 patients were hospitalized in the U.S. with acute exacerbations of COPD.
Journal reference: New England Journal of Medicine
Provided by Virginia Commonwealth University
- Commonly prescribed antibiotic reduces acute COPD attacks Aug 24, 2011 | not rated yet | 0
- LA BioMed investigators help spearhead study about novel approach to acute COPD illness Sep 06, 2011 | not rated yet | 0
- Early identification and treatment of septic shock to save lives Jun 01, 2012 | not rated yet | 0
- Low vitamin D levels do not increase the risk of chronic obstructive pulmonary disease Nov 04, 2011 | not rated yet | 0
- Antibiotics Unnecessarily Prescribed for Acute Bronchitis Nov 16, 2006 | not rated yet | 0
- Motion perception revisited: High Phi effect challenges established motion perception assumptions Apr 23, 2013 | 3 / 5 (2) | 2
- Anything you can do I can do better: Neuromolecular foundations of the superiority illusion (Update) Apr 02, 2013 | 4.5 / 5 (11) | 5
- The visual system as economist: Neural resource allocation in visual adaptation Mar 30, 2013 | 5 / 5 (2) | 9
- Separate lives: Neuronal and organismal lifespans decoupled Mar 27, 2013 | 4.9 / 5 (8) | 0
- Sizing things up: The evolutionary neurobiology of scale invariance Feb 28, 2013 | 4.8 / 5 (10) | 14
Classical and Quantum Mechanics via Lie algebras
Apr 15, 2011 I'd like to open a discussion thread for version 2 of the draft of my book ''Classical and Quantum Mechanics via Lie algebras'', available online at http://lanl.arxiv.org/abs/0810.1019 , and for the...
- More from Physics Forums - Independent Research
More news stories
There are significant cost and risk factors associated with two procedures commonly used to diagnose or treat gastrointestinal problems, according to research presented at Digestive Disease Week (DDW).
Diseases, Conditions, Syndromes 10 hours ago | not rated yet | 0
Regular consumption of coffee is associated with a reduced risk of primary sclerosing cholangitis (PSC), an autoimmune liver disease, Mayo Clinic research shows. The findings were being presented at the Digestive Disease ...
Diseases, Conditions, Syndromes 11 hours ago | not rated yet | 0 |
A new case of the deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the health ministry announced on Saturday on its Internet website.
Diseases, Conditions, Syndromes 23 hours ago | not rated yet | 0
(HealthDay)—Few randomized clinical trials have been done to assess clinical prediction rules for patients with lower back pain, and the trials that have been done are of low quality and do not provide ...
Diseases, Conditions, Syndromes May 17, 2013 | not rated yet | 0 |
A new, highly sensitive blood test that quickly detects even the lowest levels of malaria parasites in the body could make a dramatic difference in efforts to tackle the disease in the UK and across the world, according to ...
Diseases, Conditions, Syndromes May 17, 2013 | not rated yet | 0
The devastating effect of Alzheimer's disease on bilingual people has been thrown into focus in Canada, where the sudden loss of a second language can leave sufferers feeling like strangers in their own country.
1 hour ago | not rated yet | 0
The hunt for an HIV vaccine has gobbled up $8 billion in the past decade, and the failure of the most recent efficacy trial has delivered yet another setback to 26 years of efforts.
3 hours ago | not rated yet | 0
Patients with treatment-resistant major depression saw dramatic improvement in their illness after treatment with ketamine, an anesthetic, according to the largest ketamine clinical trial to-date led by researchers from the ...
11 hours ago | 4.7 / 5 (3) | 0 |
Research presented at Digestive Disease Week (DDW) explores new methods for managing digestive health through diet and lifestyle.
11 hours ago | not rated yet | 1
The use of a smartphone application significantly improves patients' preparation for a colonoscopy, according to new research presented today at Digestive Disease Week (DDW). The preparation process, which begins days in ...
10 hours ago | not rated yet | 0