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Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia

  • Authors:
    • Baohong Xiao
    • Mei Wang
    • Xiaoling Hu
    • Jinfeng Li
    • Fangfang Wang
    • Jiaxing Sun
  • View Affiliations / Copyright

    Affiliations: Department of Respiratory Medicine, The Affiliated Hospital of Qingdao University, Qingdao, Shandong 266003, P.R. China
    Copyright: © Xiao et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Pages: 1485-1489
    |
    Published online on: February 21, 2017
       https://doi.org/10.3892/etm.2017.4135
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Abstract

The present study investigated the clinical effect of antibiotic de-escalation therapy in elderly patients with chronic obstructive pulmonary disease (COPD) complicated with severe pneumonia. According to the parity method of hospitalization number, 86 cases were selected and divided into the observation and control group with 43 cases each. Based on empirical antibiotic application, levofloxacin and cephalosporin antibiotics were used in the control group. After treatment for 3 days, the regimen was adjusted to antibiotics active against Gram‑positive (G+) and Gram‑negative (G-) bacteria such as the third or fourth generation cephalosporin antibiotics, combined with aminoglycoside, or macrolide antibiotics according to their effects. The treatment effects were re‑evaluated after 3‑7 days. Finally, broad-spectrum antibiotics such as imipenem were chosen or adjusted by bacterial cultures and drug sensitivity results in the control group. Patients in the observation group were treated according to the principle of antibiotic de‑escalation therapy. Antibiotics active against G+ and G‑ bacteria were chosen as the first round of medication. After 3 days, broad‑spectrum antibiotics such as imipenem were added to the treatment regimen. After 7 days, the treatment was changed to narrow spectrum antibiotic administration if the disease was in remission, and the antibiotic regimen was adjusted based on bacterial culture and drug sensitivity results. The treatment results were compared. The mechanical ventilation rate, antibiotic courses, number of antibiotics used, and mortality of the observation group were significantly lower than those in the control group (P<0.05). After treatment, lung function improved, partial pressure of oxygen and blood oxygen saturation increased, and partial pressure of carbon dioxide decreased in both groups. The improvement of all of the above parameters were more significant in the observation group (P<0.05). After treatment, the ratio of neutrophils over white blood cells and C‑reactive protein levels of the two groups decreased, respiratory failure index (RFI) increased, and the changes were significantly more pronounced in the observation group (P<0.05). In conclusion, following the antibiotic de‑escalation principle to treat older patients with COPD complicated with severe pneumonia can reduce the number of antibiotics required, improve lung function and clinical effects, and is safe and effective.
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1 

Eom JS, Song WJ, Yoo H, Jeong BH, Lee HY, Koh WJ, Jeon K and Park HY: Chronic obstructive pulmonary disease severity is associated with severe pneumonia. Ann Thorac Med. 10:105–111. 2015. View Article : Google Scholar : PubMed/NCBI

2 

Bosc C, Clement M, Deroux A, Mammar A, Pison C and Camara B: Severe pneumonia due to cytomegalovirus in chronic obstructive pulmonary disease. Rev Mal Respir. 31:435–438. 2014.(In French). View Article : Google Scholar : PubMed/NCBI

3 

Giusti M, Blasi F, Iori I, Mazzone A, Sgambato F, Politi C, Colagrande P, Casali A, Valerio A, Gussoni G, et al: Prulifloxacin vs Levofloxacin for exacerbation of COPD after failure of other antibiotics. COPD. 30:1–6. 2016.

4 

Dy R and Sethi S: The lung microbiome and exacerbations of COPD. Curr Opin Pulm Med. 22:196–202. 2016. View Article : Google Scholar : PubMed/NCBI

5 

Wang Z, Bafadhel M, Haldar K, Spivak A, Mayhew D, Miller BE, Tal-Singer R, Johnston SL, Ramsheh MY, Barer MR, et al: Lung microbiome dynamics in COPD exacerbations. Eur Respir J. 47:1082–1092. 2016. View Article : Google Scholar : PubMed/NCBI

6 

Crisafulli E, Torres A, Huerta A, Guerrero M, Gabarrús A, Gimeno A, Martinez R, Soler N, Fernández L, Wedzicha JA, et al: Predicting in-hospital treatment failure (≤7 days) in patients with COPD exacerbation using antibiotics and systemic steroids. COPD. 13:82–92. 2016. View Article : Google Scholar : PubMed/NCBI

7 

Sharan H: Aerobic bacteriological study of acute exacerbations of chronic obstructive pulmonary disease. J Clin Diagn Res. 9:DC10–DC12. 2015.PubMed/NCBI

8 

Yamaya M: Chronic obstructive pulmonary disease and severe pneumonia. Geriatr Gerontol Int. 12:177–179. 2012. View Article : Google Scholar : PubMed/NCBI

9 

Pettigrew MM, Tsuji BT, Gent JF, Kong Y, Holden PN, Sethi S and Murphy TF: Haemophilus influenzae in COPD: Effect of fluoroquinolones and macrolides on eradication and resistance. Antimicrob Agents Chemother. 2:16–17. 2016.

10 

Sethi S, Anzueto A, Miravitlles M, Arvis P, Alder J, Haverstock D, Trajanovic M and Wilson R: Determinants of bacteriological outcomes in exacerbations of chronic obstructive pulmonary disease. Infection. 44:65–76. 2016. View Article : Google Scholar : PubMed/NCBI

11 

Gattarello S, Lagunes L, Vidaur L, Solé-Violán J, Zaragoza R, Vallés J, Torres A, Sierra R, Sebastian R and Rello J: Improvement of antibiotic therapy and ICU survival in severe non-pneumococcal community-acquired pneumonia: A matched case-control study. Crit Care. 19:3352015. View Article : Google Scholar : PubMed/NCBI

12 

Lin KY, Wang CC, Lin CH, Sheng WH and Chang SC: Fluoroquinolones versus β-Lactam/β-Lactamase inhibitors in outpatients with chronic obstructive pulmonary disease and pneumonia: A Nationwide Population-Based Study. PLoS One. 10:e01362322015. View Article : Google Scholar : PubMed/NCBI

13 

Brill SE, Law M, El-Emir E, Allinson JP, James P, Maddox V, Donaldson GC, McHugh TD, Cookson WO, Moffatt MF, et al: Effects of different antibiotic classes on airway bacteria in stable COPD using culture and molecular techniques: A randomised controlled trial. Thorax. 70:930–938. 2015. View Article : Google Scholar : PubMed/NCBI

14 

Chan KG, Ng KT, Chong TM, Pang YK, Kamarulzaman A, Yin WF and Tee KK: Antibiotic resistant and virulence determinants of staphylococcus haemolyticus C10A as revealed by whole genome sequencing. J Genomics. 3:72–74. 2015. View Article : Google Scholar : PubMed/NCBI

15 

Ma X, Cui J, Wang J, Chang Y, Fang Q, Bai C, Zhou X, Zhou H, Feng H, Wang Y, et al: Multicentre investigation of pathogenic bacteria and antibiotic resistance genes in Chinese patients with acute exacerbation of chronic obstructive pulmonary disease. J Int Med Res. 43:699–710. 2015. View Article : Google Scholar : PubMed/NCBI

16 

Hankey B and Riley B: Towards evidence based emergency medicine: best BETs from the Manchester Royal Infirmary. BET. 1:use of a procalcitonin algorithm to guide antimicrobial therapy in COPD exacerbations can reduce antibiotic consumption with no increase in rates of treatment failure or mortality. Emerg Med J 32: 493–495. 2015.

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Copy and paste a formatted citation
Spandidos Publications style
Xiao B, Wang M, Hu X, Li J, Wang F and Sun J: Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia. Exp Ther Med 13: 1485-1489, 2017.
APA
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., & Sun, J. (2017). Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia. Experimental and Therapeutic Medicine, 13, 1485-1489. https://doi.org/10.3892/etm.2017.4135
MLA
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., Sun, J."Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia". Experimental and Therapeutic Medicine 13.4 (2017): 1485-1489.
Chicago
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., Sun, J."Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia". Experimental and Therapeutic Medicine 13, no. 4 (2017): 1485-1489. https://doi.org/10.3892/etm.2017.4135
Copy and paste a formatted citation
x
Spandidos Publications style
Xiao B, Wang M, Hu X, Li J, Wang F and Sun J: Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia. Exp Ther Med 13: 1485-1489, 2017.
APA
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., & Sun, J. (2017). Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia. Experimental and Therapeutic Medicine, 13, 1485-1489. https://doi.org/10.3892/etm.2017.4135
MLA
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., Sun, J."Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia". Experimental and Therapeutic Medicine 13.4 (2017): 1485-1489.
Chicago
Xiao, B., Wang, M., Hu, X., Li, J., Wang, F., Sun, J."Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia". Experimental and Therapeutic Medicine 13, no. 4 (2017): 1485-1489. https://doi.org/10.3892/etm.2017.4135
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