Author/Editor		Mušič, Ema
Title		Vloga antibiotikov pri zdravljenju KOPB
Translated title		Role antibiotics in the management of COPD
Type		članek
Source		In: Šorli J, editor. Zbornik predavanj Obravnava bolnika s KOPB (predlogi za nacionalna priporočila); 1997 jun 13-14; Portorož. Ljubljana: Pnevmološka sekcija Slovenskega zdravniškega društva,
Publication year		1997
Volume		str. 58-65
Language		slo
Abstract		Background. Antibiotics are indicated in acute exacerbation of COPD (AECOPD) if it is due to bacterial infection. They have a positive effect on the outcome ot each AOCOPD. However, the long-term prognosis is determined by the number of AECOPD a year, degree of obstruction and pulmonary hypertension as well as the heart sufficiency. Bacterial etiology of AECOPD is different according to the stage of disease. Methods. In 908 inpatients with AECOPD the frequency of bacterial infection was measured. Apart from it, several isolated bacteria in 119 AECOPD were analysed, divided info 3 groups according to the degree of chronic obstruction. Results. In patients, who had been hospitalized for the first time, the bacterial infection was due to AECOPD in 23,6%, while in repeated hospitalization it was only 9,8%. In patients with FEV1> 1500 ml Streptococcus pneumoniae was the most frequent agent (49%), with FEV1 750-1500 Haemophilus influenzae was most frequently isolated (47%), while in even more severe obstruction this bacteria together with other Gram negative bacteria were isolated in as much as 61%. Conclusions. In mild forms of COPD the comparison of our analyses with those of other clinical investigations allows to recommend the same antibiotic therapy as that in bacterial respiratory tract infections of patients without COPD: amoxicillin or macrolide alternatively. In moderate and severe forms of COPD the antibiotic of choice is amoxicillin+clavulanic acid, and cefuroxim or kinolons alternalively. Due to its favourable postantibiotic effect, the dose of amoxicillin 875 mg+clavulanic acid 125 mg could be administered every 12 hours.
Descriptors		LUNG DISEASES, OBSTRUCTIVE ANTIBIOTICS PRACTICE GUIDELINES