scholarly journals Frequency of acute exacerbation of chronic obstructive pulmonary disease in patients taking low dose azithromycin prophylaxis.

2020 ◽  
Vol 27 (11) ◽  
pp. 2438-2444
Author(s):  
Muhammad Absar Alam ◽  
Muhammad Sarfraz ◽  
Arsalan Hafeez ◽  
Zafar Ali Zafar ◽  
Touseef Anwar ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Low Dose ◽  
Operational Definition ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease ◽  
Duration Of Disease

Objectives: To assess the frequency of acute exacerbation of chronic obstructive pulmonary disease in patients taking low dose azithromycin prophylaxis. Study Design: Cross Sectional study. Setting: Department of Medicine, Independent University Hospital, Faisalabad. Period: 01-07-2017 to 30-06-2018. Material & Methods: 100 patients having diagnosis of COPD according to the operational definition were selected from medical opd of hospital after consent of patients. All patients were given tablet azithromycin 250mg thrice weekly for 12 months, then these patients were followed up for episodes of exacerbations in one year. All patients were properly instructed to report in any change in their symptoms. Any episode of acute exacerbation was noted. There was no conflict of interest. Results: Frequency of acute exacerbation of chronic obstructive pulmonary disease was seen in 70 out of 100(70%) patients taking low dose azithromycin prophylaxis. In female patients frequency of acute exacerbation was high as compared to male patients. i.e. 62.9% vs. 37.1%. Frequency of acute exacerbation was higher in patients whose duration of disease was longer. i.e. 7-10 years followed by patients whose duration of disease was 4-6 years (28.6%) and 1-3 years (25.7%). Presence of acute exacerbation was significantly associated with decline in lung functions. Highest frequency of acute exacerbation was seen in patients who had 3-4 episodes. Conclusion: Results of this study showed a high frequency of acute exacerbation of COPD even with the prophylaxis of low dose azithromycin. However literature reported effectiveness of low dose azithromycin for acute exacerbation in patients of COPD. So further study in the form of randomized trail is needed to prove the efficacy of azithromycin.

Microbiological Etiology of Chronic Cough Associated with Acute Exacerbation of Chronic Obstructive Pulmonary Disease (COPD): A Study from Karachi, Pakistan

2020 ◽  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Tertiary Care ◽  
Environmental Pollutants ◽  
Sputum Culture ◽  
Chronic Obstructive ◽  
Care Hospital ◽  
Cross Sectional ◽  
Obstructive Pulmonary Disease

Background: Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) worsens the respiratory symptoms that are usually triggered by infection with bacteria or viruses or by environmental pollutants. Therefore, the aim of this study was to determine the bacterial etiology from sputum culture in patients suffering from acute exacerbation of COPD, admitted in hospital. Methods: The study was cross sectional observational, where sputum bacterial cultures were analyzed from the patients with Acute exacerbation COPD treated in the ICU of a tertiary care hospital for pulmonary disease from January 2019 to December 2019. Two sputum samples were collected from each patient for bacterial examination. The results of sputum bacterial culture findings were expressed as frequency and percentage by using SPSS. Results: In the present study, there were 1296 patients, both males 749 (57.8%) and females 547 (42.2%). The mean age of patients was 57.39±19.74years. 470 (36.3%) showed negative culture reports. 440 (34.0%) patients had Moraxella infection, which was most common organism in all patients, and 149 (11.5%) patients had Pseudomonas infection, 157(12.1%) patients had Yeast Albicans and in only 1 (0.1%) patient Enterobacter infection were found. Other pathogens in low frequency identified were Haemophilus parainfluenzae, Streptococcus pneumoniae, Escherichia coli and Haemophilus influenzae. It was observed that the frequency of infections was linked with increasing age. Conclusion: With increasing age, people are prone to acquire pulmonary infections specifically COPD. It is therefore very important to perform sputum culture to identify the causative agents and treat the patients with appropriate antibiotic to reduce the episodes of AECOPD. Keywords: Bacteria; Sputum Culture; COPD; Antibiotic; Cough.

scholarly journals The Impact of Community-acquired Pneumonia on Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients as Regards In-hospital Complications and Early Readmission

2020 ◽  
Vol 14 (1) ◽  
pp. 10-15
Author(s):  
Dina Ruby
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Community Acquired Pneumonia ◽  
University Hospital ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Patients ◽  
Early Readmission ◽  
The Impact

Background and Objective: Pneumonia is a major reason for hospitalization for Acute Exacerbation of Chronic Obstructive Pulmonary Disease patients (AECOPD). There is limited data available on the outcomes of AECOPD patients with or without pneumonia. Therefore, the study investigates the prognosis of AECOPD patients with or without Community-acquired Pneumonia (CAP), concerning the Length of Hospital Stay (LOS), in-hospital complications and early readmission. Methods: This study was carried out on 100 male COPD patients without CAP, 90 patients with CAP who were admitted to the chest department of Ain Shams University hospital over a 1-year period. Data collection about LOS, in-hospital complications, was recorded and they were followed for 30 days to detect acute readmission. Results: The mean age was 64± 8 years old in COPD patients without CAP to 62± 12year old in patients with CAP, LOS in COPD patients with CAP was 11.30 ± 3.23 days to 7.57 ± 2.24 in patients without CAP, COPD patients with CAP had a higher rate of complications in comparison to those without CAP as 45.6%, 13% were admitted to Intensive Care Unit (ICU) respectively, 15.6%, 3% were mechanically ventilated respectively. LOS and C- Reactive Protein (CRP) were significant causes for readmission in COPD patients with and without CAP. Conclusion: COPD patients with CAP had longer LOS and more short term complications as ICU admission, mechanical ventilation and higher readmission rate in comparison to COPD patients without CAP.

Level of Adherence to GOLD Guidelines for Management of Patients with Acute Exacerbation of Chronic Obstructive Pulmonary Disease: Is There a Difference Between Patient Management in Different Hospital Wards?

2021 ◽  
Author(s):  
Omolbanin Paknejad ◽  
Akram Shiri ◽  
Zeinab Naderpour
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Chronic Obstructive ◽  
Cross Sectional ◽  
Pharmacological Management ◽  
Obstructive Pulmonary Disease ◽  
Pharmacologic Management ◽  
High Level

Background: The purpose of this study was to evaluate the implementation of GOLD guideline in patients with an acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD).  Methods: In a cross-sectional study, all patients with COPD exacerbation referred to Shariati hospital from January 2014 to March 2015 were investigated. The level of adherence to GOLD guideline in three areas of hospital admission, therapeutic components of inpatient management (pharmacologic treatments, respiratory support) and discharge plan was assessed via reviewing patients’ medical profile. Each subject was classified as complete, non-complete and not evaluated in terms of adherence to the guideline. Results: In this study, 125 patients with mean age of 67.64±1.71 years including 100 (80%) males were studied. Also, 104 and 21 patients were hospitalized in pulmonology and general medicine wards, respectively. In the present study, the adherence to GOLD recommendations for hospital admission, pharmacologic treatment and non-pharmacologic management were 92, 97.6 and 44.2%, respectively. Despite the high level of adherence to pharmacologic management, total adherence to non-pharmacologic interventions was poor. Conclusion: Although high level of adherence to pharmacological management of COPD was observed, there was overtreatment particularly in case of antibiotics prescription. In addition, non-pharmacological management was not considered in over half of the patients.

Optimal glucocorticoid dose and the effects on mortality, length of stay, and readmission rates in patients diagnosed with acute exacerbation of chronic obstructive pulmonary disease (AECOPD)

2019 ◽  
Vol 67 (8) ◽  
pp. 1161-1164
Author(s):  
Asim Kichloo ◽  
Michael Aljadah ◽  
Navya Vipparla ◽  
Farah Wani
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Acute Exacerbation ◽  
Low Dose ◽  
Future Research ◽  
Chronic Obstructive ◽  
High Dose ◽  
Readmission Rates ◽  
Glucocorticoid Treatment ◽  
Obstructive Pulmonary Disease

The burden of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is staggering on a national and global level. Yet, surprisingly, there is a profound lack of treatment standardization with glucocorticoids in the treatment of AECOPD. In this review, we bring attention to specific literature that use a cut-off of 60 mg prednisone equivalent per day when distinguishing between high-dose and low-dose glucocorticoid treatment. We hope this review encourages future research to begin incrementally lowering the cut-off dose of 60 mg to discover if mortality, length of hospital stays, and readmission rates change between high-dose and low-dose glucocorticoid treatment. The final hope would be to establish an optimal glucocorticoid dose to treat AECOPD and eliminate treatment ambiguity.

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