Antibacterial treatment of moderate chronic obstructive pulmonary disease exacerbation

Abstract

Chronic obstructive pulmonary disease (COPD) is one of the main causes of morbidity and mortality worldwide. Time to time, the natural progres sive course of COPD is interfered by exacerbations which lead to further lung function worsening. Adequate antibacterial therapy could diminish unfavorable inflammation effects and prolong time to the next exacerbation in patients with Anthonisen's type 1 and type 2 exacerbations. Given the leading role of Haemophilus influenzae and Streptococcus pneumonia as causative agents in COPD exacerbations, amoxicillin is recommended as the first choice drug in lowrisk patients with nonsevere COPD exacerbation. Amoxicillin is also active against 97% of H. influenzae strains in Russia. In patients with poor tolerance of penicillins, if not related to IgE, administration of cefixime, which is highly active against H. influenza and moderately active against S. pneumonia, is reasonable. In case of βlactam intolerance respiratory fluoroquinolones could be considered as alternative drugs.