Abstract
Background
Acute exacerbations of COPD (AECOPD) may be due to bacterial or viral infection or exposure to irritants. Anecdotally we have observed antibiotic prescribing with no evidence of bacterial infection. We aimed to compare clinical and biochemical admission characteristics with antibiotic prescribing during AECOPD.
Methods
We reviewed two months of AECOPD admissions to our tertiary hospital collecting data on sputum volume and purulence, total white cell count (WCC), C-reactive protein (CRP), CXR changes and antibiotic prescribing.
Results
117 (74%) of all admission case notes were reviewed (mean age 72.5 yr; 58M, 59F). 89 (76%) patients received antibiotics for their exacerbation. Table 1 summarises antibiotic prescribing related to inflammatory markers and change in sputum and CXR.
Appropriate antibiotic prescribing (100%) was given to all patients with raised WCC and CRP with consolidation, and raised WCC and CRP with sputum change. However 68% of patients with normal WCC and CRP received antibiotics.
Conclusion
Patients with infective symptoms and raised biomarkers are being appropriately treated. However there are patients who receive antibiotics with no evidence of bacterial infection with subsequent unnecessary medications and antibiotic resistance.
- © 2014 ERS