2 days ago
Short Fluoroquinolone Regimen Matches Conventional COPD Care
A short-course fluoroquinolone treatment (< 5 days) was as effective as the conventional 7-day course in resolving clinical symptoms of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), while causing fewer adverse events.
METHODOLOGY:
Researchers conducted a meta-analysis of nine double-blind studies to examine if short-duration is as effective as conventional 7-day duration using fluoroquinolone therapy for AECOPD.
The analysis included 3951 adults diagnosed with AECOPD who had not received antimicrobial therapy at the time of diagnosis; of these, 1988 were allocated to short-course treatment and 1963 to long-course treatment with fluoroquinolones.
The main outcome was clinical cure at early follow-up, defined as the resolution or improvement of the clinical symptoms of exacerbation.
Follow-up evaluations were conducted 3-10 days (early) and 25-30 days (late) after treatment completion.
TAKEAWAY:
The clinical cure rate within 5-20 days of treatment completion was not significantly different between the short-course and conventional-course fluoroquinolone treatments (odds ratio [OR], 1.00; P = .82).
= .82). Similarly, bacteriologic clearance was not significantly different between both treatment regimens at both early and late follow-up ( P = .73).
= .73). Compared with long-course therapy, short-course treatment resulted in significantly fewer adverse events (OR, 0.76; P < .05).
IN PRACTICE:
'We suggest that the guidelines for the treatment of COPD should recommend a total course of 5 days or less of quinolones regardless of the molecule selected, if we want to avoid antibiotic overconsumption, to slow the emerging curb of the continuous antimicrobial resistance, to improve treatment compliance, and to potentially alleviate the socioeconomic burden of the management of AECOPD,' the authors wrote.
SOURCE:
This study was led by Salma Messous, PhD, Fattouma Bourguiba University Hospital, Monastir, Tunisia. It was published online on May 24, 2025, in Clinical Therapeutics .
LIMITATIONS:
This study excluded patients with respiratory or hemodynamic failure; therefore, the results might not be generalizable to all patients. Additionally, a better definition is needed to determine which patients would benefit from antibiotic treatment, as exacerbations are not always caused by pathogenic bacteria.
DISCLOSURES:
The research did not receive any funding. The authors reported having no conflicts of interest.
