title: Systematic review and meta-analysis of prophylactic antibiotics in COPD and/or chronic bronchitis.
abstract: BACKGROUND
  Exacerbations contribute substantially to the morbidity and mortality associated with chronic obstructive pulmonary disease (COPD).
  
  
  OBJECTIVE
  To assess whether prophylactic antibiotic treatment reduces exacerbations in patients with COPD and/or chronic bronchitis.
  
  
  METHODS
  Medline, EMBASE, Cochrane Central Register of Controlled Trials, Koreamed and references from relevant publications were searched up to October 2011. Randomised controlled trials comparing the effect of any prophylactic antibiotics with placebo for at least 3 months were included. The co-primary  outcomes were the frequency of exacerbations of COPD or chronic bronchitis and adverse treatment events.
  
  
  RESULTS
  A total of 19 trials involving 3932 subjects were included in the analysis: 5 recent trials included patients with moderate to severe COPD, whereas 14 older trials included  patients with chronic bronchitis. The use of antibiotics significantly reduced the rate of COPD exacerbations (risk ratio [RR] 0.73, 95%CI 0.66-0.82), the number of chronic bronchitis exacerbations (standardised mean difference -0.23, 95%CI -0.35--0.11) and the  proportion of patients with exacerbations of chronic bronchitis (RR 0.93, 95%CI 0.87-0.99).
  
  
  CONCLUSIONS
  Prophylactic antibiotic treatment has a significant effect in reducing exacerbations in patients with COPD and/or chronic bronchitis.
authors: Department of Pulmonary and Critical Care Medicine, and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
authors: J S
authors: JS
authors: Lee
authors: D-A
authors: DA
authors: Park
authors: Y
authors: Y
authors: Hong
authors: K W
authors: KW
authors: Jo
authors: S W
authors: SW
authors: Lee
authors: J W
authors: JW
authors: Huh
authors: Y-M
authors: YM
authors: Oh
authors: S-D
authors: SD
authors: Lee
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019072:Antibiotic Prophylaxis / Q000379:methods*; D029481:Bronchitis, Chronic / Q000188:drug therapy*; D006801:Humans; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*; D055502:Secondary Prevention
chemical_list: D000900:Anti-Bacterial Agents