Antibiotic treatment of exacerbations of COPD in general practice: long-term impact on health-related quality of life.
OBJECTIVE
To investigate the impact of exacerbations in health-related quality of life (HRQL) of patients with COPD and to compare the effect of treatment of COPD exacerbations with moxifloxacin (400 mg/day for 5 days) and amoxicillin/clavulanate (500/125 mg 3 times a day for 10 days) on HRQL.


METHODS
229 outpatients with stable COPD (mean age 68.2 years; mean FEV(1) % predicted 49.3%) participated in a prospective, observational study of 2 years' duration. The St George's Respiratory Questionnaire (SGRQ) was completed at baseline and every 6 months thereafter.


RESULTS
COPD exacerbations (mean 2.7 episodes/patient) occurred in 136 patients (124 patients received the study medications [amoxicillin/clavulanate 54, moxifloxacin 70]). Differences between baseline and the final visit were higher for moxifloxacin compared with amoxicillin/clavulanate for total SGRQ score (-2.60 [13.1] vs 4.21 [16.2], P = 0.05) and "Symptoms" subscale (-5.64 [16.7] vs 8.27 [21], P = 0.02). The same findings were observed in patients with two or more exacerbations.


CONCLUSIONS
In COPD outpatients, treatment of exacerbations with moxifloxacin had a more favorable long-term effect on quality of life than amoxicillin/clavulanate.
Miravitlles
Marc
M
Fundació Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Hospital Clínic, Ciber de Enfermedades Respiratorias, Barcelona, Spain. marcm@separ.es
Llor
Carles
C
Molina
Jesús
J
Naberan
Karlos
K
Cots
Josep M
JM
Ros
Fernando
F
D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019370:Observation; D010818:Practice Patterns, Physicians'; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy* / Q000503:physiopathology; D011788:Quality of Life; D013030:Spain
D000900:Anti-Bacterial Agents