THE EFFECTIVENESS OF PROPHYLACTIC ANTIBIOTICS IN PREVENTING AECOPD.

BACKGROUND: Recent studies have predicted that by 2030, chronic obstructive pulmonary disease (COPD) will become the 3rd leading cause of death worldwide. COPD is both a treatable and preventable disease, which affects mostly those who currently smoke or have a history of smoking. Acute exacerbations of COPD (AECOPD) will occur on average of 1.4 times per year per patient, which will likely send these patients to the hospital resulting in an increased cost of health care as well as a decline in the patient's quality of life and lung function. The use of prophylactic antibiotics to prevent AECOPD is a growing interest; however, they are not standardized in the treatment of COPD in conjunction with current medication therapy. OBJECTIVES: To determine whether or not the use of prophylactic antibiotics is effective in preventing acute exacerbations in patients with COPD. METHODS: A systematic literature search was conducted in January 2017 using the following computerized databases: PubMed and Ovid Medline. Randomized controlled trials (RCTs) were the only publications of interest in the search. A secondary search was performed by reviewing the citations of relevant publications. RESULTS: Twenty-five publications were identified in total after conducting the primary and secondary search. After applying inclusion and exclusion criteria and screening the abstract and full-text articles, two RCTs were included in the present literature review. Both RCTs reviewed in the present literature review were double-blind, placebo-controlled studies, which were interested in the frequency of AECOPD during the study trial. One study showed evidence that prophylactic antibiotics reduced the frequency of AECOPD and improved quality of life at the expense of possibly acquiring antimicrobial resistance. In contrast, one study showed no evidence of the emergence of antimicrobial resistance; however, the use of antibiotics did not significantly reduce the frequency of AECOPD. CONCLUSIONS: Each study conducted showed a reduction in hospital admissions; however, they both lacked data that proved the safety and effectiveness after one year. [ABSTRACT FROM AUTHOR]