Active Ingredient: Doxycycline
Table 2 Baseline characteristics of participants by treatment groups Primary outcome COPD exacerbations over 48-week post-treatment period The annualised moderate and severe event rates were 2.Alcohol factors like those for a medicine are doctor online propecia consistently still provided an also larger niet.
The Cochrane review by Staykova et al published in analysed nine randomised controlled trials all undertaken prior to 1970 of prophylactic antibiotic therapy in subjects with chronic bronchitis.
There was no significant reduction in exacerbation rate seen with tetracycline only studies. The finding of the lack of effect of prophylactic antibiotic use seen in our study is therefore in agreement with the findings from these historical prophylactic antibiotic studies.
Since this study was undertaken, a number of prophylactic antibiotic trials have been undertaken using newer macrolides and fluoroquinolones.
These studies followed the documented efficacy of macrolide therapy in the cystic fibrosis CF population and more recently in non-CF bronchiectasis. In accordance with our findings, there was no statistically significant difference in COPD hospitalisations 0.
Unlike our study, half of the patients did not have history of frequent exacerbations, hence the lower annualised exacerbation rates and longer duration to first exacerbation.
The overall exacerbation rate was significantly lower in the azithromycin group than placebo 1. However, the rates of severe exacerbation and hospitalisation were not statistically different.
They did not find any significant improvement in lung function and overall health-related quality of life. Although we observed a similar trend in our study, our results were not statistically significant.
We found that the adverse events from prophylactic antibiotics were tolerable and apart from nausea, were comparable between the treatment groups.
Macrolides, however, are known to have cardiac side effects e. A retrospective study on azithromycin by Ray et al showed that its use was associated with increased cardiovascular deaths. Erythromycin and azithromycin are also potent inducers of antimicrobial resistance in both non-CF bronchiectasis and COPD studies.
Herath et al, although unable to analyse the development of antibiotic resistance in their review, conveyed their concern on the impact of bacterial macrolide resistance as observed in the study by Albert et al.
The more recent trials by Uzun et al and Brill et al have also shown the development of antimicrobial resistance.
Our study in which antibiotics were given for twelve weeks did not examine antimicrobial resistance.
The patient was treated with 400 mg of moxifloxacin oral daily and 500 mg of azithromycin daily for an anticipated 6-month course. The tigecycline MIC was 0. Her wounds healed well with improvement in pain, edema, and hand function.