title: Pharmacotherapy for lower respiratory tract infections.
abstract: BACKGROUND
  Bacterial infections play an important role as etiological agents in acute exacerbations of chronic obstructive pulmonary disease (AECOPD), and exacerbations of non-cystic fibrosis (CF) bronchiectasis. In acute bronchitis and asthma exacerbations their role is less well defined than with patients with COPD. The clinical features, causative pathogens and therapies of common acute respiratory tract infections are detailed in this review.
  
  
  METHODS
  This article covers medical literature published in any language from 2000 to 2014, on 'lower respiratory tract infections', identified using PubMed, MEDLINE and ClinicalTrial.gov. The search terms used were 'COPD exacerbations', 'bronchiectasis', 'macrolides' and 'inhaled antibiotics'.
  
  
  CONCLUSIONS
  Given that almost half of AECOPD are caused by bacteria, administration of antibacterial agents is recommended for patients with severe exacerbations or severe underlying COPD. Chronic prophylactic use of macrolides seems to be of benefit, particularly in patients with bronchiectasis and chronic mucous hypersecretion. In an effort to manage chronic airway infection non-CF bronchiectasis due to drug-resistant pathogens, aerosolized antibiotics may be of value, and the data from recent studies are examined to demonstrate the potential value of this therapy, which is often used as an adjunctive measure to systemic antimicrobial therapy.
authors.forename: Adamantia
authors.initials: A
authors.lastname: Liapikou
authors.affiliation: Sotiria Hospital, 6th Respiratory Department , Mesogion 152, 11527, Athens , Greece +30 2107763458 ; mliapikou@yahoo.com.
authors.forename: Liapikou
authors.initials: L
authors.lastname: Adamantia
authors.forename: Antoni
authors.initials: A
authors.lastname: Torres
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
mesh_terms: D000208:Acute Disease; D000280:Administration, Inhalation; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D001424:Bacterial Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology; D001987:Bronchiectasis / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D001991:Bronchitis / Q000188:drug therapy / Q000209:etiology; D002908:Chronic Disease; D018450:Disease Progression; D024881:Drug Resistance, Bacterial; D006801:Humans; D018942:Macrolides / Q000627:therapeutic use; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology; D012141:Respiratory Tract Infections / Q000150:complications / Q000188:drug therapy* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D018942:Macrolides
keywords: acute bronchitis; inhaled antibiotics; macrolides; non-cystic fibrosis bronchiectasis