title: [Antimicrobial treatment of patients with severe acute exacerbation of COPD].
abstract: Chronic obstructive lung disease (COPD) is a leading cause of death worldwide. In patients with acute exacerbations admitted to an intensive care unit (ICU), potentially pathogenic microorganisms can be found in approximately 50%, with Haemophilus influenzae and Streptococcus pneumoniae as the leading strains, followed by enterobacteria and Pseudomonas aeruginosa. Viruses can also be detected in a large proportion of patients. The indication for antimicrobial treatment of acutely exacerbated COPD is still controversial but recommended by guidelines for all patients admitted to an ICU. Appropriate agents for an empiric initial treatment are penicillins + betalactamase inhibitor, 2(nd) and 3(rd) generation cephalosporins, carbapenems, and quinolones. Antimicrobial treatment should be adjusted according to the results of microbial investigation of sputum or endotracheal aspirate.
authors.affiliation: Thoraxzentrum Ruhrgebiet, Kliniken für Pneumologie und Infektiologie, EVK Herne und Augusta-Krankenanstalt Bochum, Bergstr. 26, 44791, Bochum, Deutschland.
authors.forename: B
authors.initials: B
authors.lastname: Klapdor
authors.forename: S
authors.initials: S
authors.lastname: Ewig
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D018450:Disease Progression; D024901:Drug Resistance, Multiple, Bacterial; D004756:Enterobacteriaceae Infections / Q000175:diagnosis / Q000188:drug therapy; D005858:Germany; D019983:Guideline Adherence; D006192:Haemophilus Infections / Q000175:diagnosis / Q000188:drug therapy; D006193:Haemophilus influenzae; D006801:Humans; D007362:Intensive Care Units; D008826:Microbial Sensitivity Tests; D011008:Pneumococcal Infections / Q000175:diagnosis / Q000188:drug therapy; D018410:Pneumonia, Bacterial / Q000175:diagnosis / Q000188:drug therapy*; D011552:Pseudomonas Infections / Q000175:diagnosis / Q000188:drug therapy; D011550:Pseudomonas aeruginosa; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000188:drug therapy*; D013183:Sputum / Q000382:microbiology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents