Treatment of patients hospitalized for exacerbations of chronic obstructive pulmonary disease: comparison of an oral/metered-dose inhaler regimen and an intravenous/nebulizer regimen.
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.
Shortall
Sean P
SP
Penobscot Respiratory, 417 State Street, Suite 400, Bangor ME 04401, USA.
Blum
James
J
Oldenburg
Frederick A
FA
Rodgerson
Lorraine
L
Branscombe
John M
JM
Harrow
Edward M
EM
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
D001993:Bronchodilator Agents; D002511:Cephalosporins; D005938:Glucocorticoids; D009241:Ipratropium; D002444:Cefuroxime; D000420:Albuterol; D008775:Methylprednisolone