title: Treatment of patients hospitalized for exacerbations of chronic obstructive pulmonary disease: comparison of an oral/metered-dose inhaler regimen and an intravenous/nebulizer regimen.
abstract: OBJECTIVE
  Compare the therapeutic efficacy of an oral/metered-dose inhaler (oral/MDI) regimen to an intravenous/nebulizer (I.V./neb) regimen of methylprednisolone, cefuroxime, and inhaled albuterol and ipratropium bromide in patients hospitalized for exacerbations of chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Randomized, nonblinded, therapeutic trial.
  
  
  METHODS
  Two community hospitals in Bangor, Maine.
  
  
  METHODS
  34 individuals with severe COPD. The mean admission forced expiratory volume in the first second was 0.75 L (oral/MDI 0.78 L, I.V./neb 0.71 L).
  
  
  RESULTS
  Baseline demographic, laboratory, comorbidity, and ventilatory values determined in 19 patients who received the oral/MDI regimen and 15 patients treated with the I.V./neb regimen indicated comparability of the two groups. Outcome variables that compared oral/MDI to I.V./neb, including mean change in forced expiratory volume in the first second (0.12 L vs 0.13 L), mean length of stay (4.3 vs 5.1 d), and treatment failures (32% vs 33%), showed no significant differences.
  
  
  CONCLUSIONS
  Patients hospitalized for COPD exacerbations can be successfully (and potentially less expensively) treated with an oral/MDI treatment regimen.
authors.affiliation: Penobscot Respiratory, 417 State Street, Suite 400, Bangor ME 04401, USA.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Shortall
authors.forename: James
authors.initials: J
authors.lastname: Blum
authors.forename: Frederick A
authors.initials: FA
authors.lastname: Oldenburg
authors.forename: Lorraine
authors.initials: L
authors.lastname: Rodgerson
authors.forename: John M
authors.initials: JM
authors.lastname: Branscombe
authors.forename: Edward M
authors.initials: EM
authors.lastname: Harrow
mesh_terms: D000280:Administration, Inhalation; D000284:Administration, Oral; D000368:Aged; D000420:Albuterol / Q000008:administration & dosage; D001993:Bronchodilator Agents / Q000008:administration & dosage*; D002444:Cefuroxime / Q000008:administration & dosage*; D002511:Cephalosporins / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D005260:Female; D005541:Forced Expiratory Volume / Q000187:drug effects; D005938:Glucocorticoids / Q000008:administration & dosage*; D006760:Hospitalization; D006801:Humans; D007262:Infusions, Intravenous; D009241:Ipratropium / Q000008:administration & dosage; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D009330:Nebulizers and Vaporizers; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D001993:Bronchodilator Agents; D002511:Cephalosporins; D005938:Glucocorticoids; D009241:Ipratropium; D002444:Cefuroxime; D000420:Albuterol; D008775:Methylprednisolone