title: Antibiotic Prescription for COPD Exacerbations Admitted to Hospital: European COPD Audit.
abstract: OBJECTIVE
  Appropriate use of antibiotics in the management of hospitalised patients with COPD exacerbations is defined within the GOLD strategy. This paper analyses the factors associated with antibiotic prescribing in patients to better understand how prescribing may be improved.
  
  
  METHODS
  The European COPD audit was a study of clinical care in 384 hospitals from 13 European countries between 2010 and 2011 enrolling 16018 patients. Those admitted to hospital due to a clinician-made diagnosis of exacerbation of COPD at the time of discharge were audited. We defined antibiotic prescribing compliance as consistent with the GOLD 2010 recommendations. Two different multivariate models were used to evaluate factors associated with the prescription of antibiotics and the guideline-compliant prescriptions.
  
  
  RESULTS
  Overall 86% of admissions were given antibiotics but only 61.4% cases met the GOLD recommendations. Antibiotics were more likely to be given in hospital and at discharge if received prior to admission. Antibiotic prescription was more likely in patients who met the GOLD recommendations and in those with radiological consolidation but there was also a significant use of antibiotics in patients who did not meet either criterion. Patients cared for on a Respiratory Ward were more likely to receive GOLD compliant antibiotic management.
  
  
  CONCLUSIONS
  The present study describes the audited in-hospital antibiotic prescription for COPD exacerbation across different European countries. In general, there is an apparent overuse of antibiotics likely to be associated with both patient and practice-related variables.
authors.affiliation: Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla (IBiS), Seville, Spain; CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: López-Campos
authors.affiliation: Ludwig Boltzmann Institute of COPD and Respiratory Epidemiology, Vienna, Austria.
authors.forename: Sylvia
authors.initials: S
authors.lastname: Hartl
authors.affiliation: CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain; Hospital 12 de Octubre, Instituto de Investigación i+12, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Pozo-Rodriguez
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, United Kingdom.
authors.forename: C Michael
authors.initials: CM
authors.lastname: Roberts
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017723:Drug Utilization Review; D005060:Europe; D006801:Humans; D008485:Medical Audit; D010343:Patient Admission; D029424:Pulmonary Disease, Chronic Obstructive / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents