Publication

Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials

Wang, Y., Zijp, T. R., Bahar, M. A., Kocks, J. W. H., Wilffert, B. & Hak, E., Dec-2018, In : Journal of Antimicrobial Chemotherapy. 73, 12, p. 3231–3243

Research output: Contribution to journalArticleAcademicpeer-review

APA

Wang, Y., Zijp, T. R., Bahar, M. A., Kocks, J. W. H., Wilffert, B., & Hak, E. (2018). Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials. Journal of Antimicrobial Chemotherapy, 73(12), 3231–3243. https://doi.org/10.1093/jac/dky326

Author

Wang, Yuanyuan ; Zijp, Tanja R ; Bahar, Muh Akbar ; Kocks, Janwillem W H ; Wilffert, Bob ; Hak, Eelko. / Effects of prophylactic antibiotics on patients with stable COPD : a systematic review and meta-analysis of randomized controlled trials. In: Journal of Antimicrobial Chemotherapy. 2018 ; Vol. 73, No. 12. pp. 3231–3243.

Harvard

Wang, Y, Zijp, TR, Bahar, MA, Kocks, JWH, Wilffert, B & Hak, E 2018, 'Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials', Journal of Antimicrobial Chemotherapy, vol. 73, no. 12, pp. 3231–3243. https://doi.org/10.1093/jac/dky326

Standard

Effects of prophylactic antibiotics on patients with stable COPD : a systematic review and meta-analysis of randomized controlled trials. / Wang, Yuanyuan; Zijp, Tanja R; Bahar, Muh Akbar; Kocks, Janwillem W H; Wilffert, Bob; Hak, Eelko.

In: Journal of Antimicrobial Chemotherapy, Vol. 73, No. 12, 12.2018, p. 3231–3243.

Research output: Contribution to journalArticleAcademicpeer-review

Vancouver

Wang Y, Zijp TR, Bahar MA, Kocks JWH, Wilffert B, Hak E. Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials. Journal of Antimicrobial Chemotherapy. 2018 Dec;73(12):3231–3243. https://doi.org/10.1093/jac/dky326


BibTeX

@article{39dfe349b8e1482ea3c31f6c31d207f9,
title = "Effects of prophylactic antibiotics on patients with stable COPD: a systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: As bacterial infections provoke exacerbations, COPD patients may benefit from prophylactic antibiotics. However, evidence regarding their overall benefit-risk profile is conflicting.Objectives: To update previous evidence and systematically evaluate the beneficial effects and side effects of prophylactic antibiotics in stable COPD patients.Methods: Several databases were searched up to 26 April 2017 for randomized controlled trials (RCTs) on prophylactic antibiotics in stable COPD patients. The primary outcomes were exacerbations and quality of life. Duration and schedule of antibiotics were considered in subgroup analyses.Results: Twelve RCTs involving 3683 patients were included. Prophylactic antibiotics significantly reduced the frequency of exacerbations [risk ratio (RR) 0.74, 95% CI 0.60-0.92] and the number of patients with one or more exacerbations (RR 0.82, 95% CI 0.74-0.90). Erythromycin and azithromycin appeared the most effective, with the number needed to treat ranging from four to seven. Quality of life was also significantly improved by prophylactic antibiotics (mean difference -1.55, 95% CI -2.59 to -0.51). Time to first exacerbation was prolonged in six studies, with one conflicting result. Neither the rate of hospitalization nor the rate of adverse events was significantly changed. Furthermore, no significant changes were observed in lung function, bacterial load and airway inflammation. However, antibiotic-resistant isolates were significantly increased (OR 4.49, 95% CI 2.48-8.12).Conclusions: Prophylactic antibiotics were effective in preventing COPD exacerbations and improving quality of life among stable patients with moderate to severe COPD. The choice of prophylactic antibiotics should be analysed and considered case by case, especially for long and continuous use.",
author = "Yuanyuan Wang and Zijp, {Tanja R} and Bahar, {Muh Akbar} and Kocks, {Janwillem W H} and Bob Wilffert and Eelko Hak",
year = "2018",
month = dec,
doi = "10.1093/jac/dky326",
language = "English",
volume = "73",
pages = "3231–3243",
journal = "Journal of Antimicrobial Chemotherapy",
issn = "0305-7453",
publisher = "Oxford University Press",
number = "12",

}

RIS

TY - JOUR

T1 - Effects of prophylactic antibiotics on patients with stable COPD

T2 - a systematic review and meta-analysis of randomized controlled trials

AU - Wang, Yuanyuan

AU - Zijp, Tanja R

AU - Bahar, Muh Akbar

AU - Kocks, Janwillem W H

AU - Wilffert, Bob

AU - Hak, Eelko

PY - 2018/12

Y1 - 2018/12

N2 - Background: As bacterial infections provoke exacerbations, COPD patients may benefit from prophylactic antibiotics. However, evidence regarding their overall benefit-risk profile is conflicting.Objectives: To update previous evidence and systematically evaluate the beneficial effects and side effects of prophylactic antibiotics in stable COPD patients.Methods: Several databases were searched up to 26 April 2017 for randomized controlled trials (RCTs) on prophylactic antibiotics in stable COPD patients. The primary outcomes were exacerbations and quality of life. Duration and schedule of antibiotics were considered in subgroup analyses.Results: Twelve RCTs involving 3683 patients were included. Prophylactic antibiotics significantly reduced the frequency of exacerbations [risk ratio (RR) 0.74, 95% CI 0.60-0.92] and the number of patients with one or more exacerbations (RR 0.82, 95% CI 0.74-0.90). Erythromycin and azithromycin appeared the most effective, with the number needed to treat ranging from four to seven. Quality of life was also significantly improved by prophylactic antibiotics (mean difference -1.55, 95% CI -2.59 to -0.51). Time to first exacerbation was prolonged in six studies, with one conflicting result. Neither the rate of hospitalization nor the rate of adverse events was significantly changed. Furthermore, no significant changes were observed in lung function, bacterial load and airway inflammation. However, antibiotic-resistant isolates were significantly increased (OR 4.49, 95% CI 2.48-8.12).Conclusions: Prophylactic antibiotics were effective in preventing COPD exacerbations and improving quality of life among stable patients with moderate to severe COPD. The choice of prophylactic antibiotics should be analysed and considered case by case, especially for long and continuous use.

AB - Background: As bacterial infections provoke exacerbations, COPD patients may benefit from prophylactic antibiotics. However, evidence regarding their overall benefit-risk profile is conflicting.Objectives: To update previous evidence and systematically evaluate the beneficial effects and side effects of prophylactic antibiotics in stable COPD patients.Methods: Several databases were searched up to 26 April 2017 for randomized controlled trials (RCTs) on prophylactic antibiotics in stable COPD patients. The primary outcomes were exacerbations and quality of life. Duration and schedule of antibiotics were considered in subgroup analyses.Results: Twelve RCTs involving 3683 patients were included. Prophylactic antibiotics significantly reduced the frequency of exacerbations [risk ratio (RR) 0.74, 95% CI 0.60-0.92] and the number of patients with one or more exacerbations (RR 0.82, 95% CI 0.74-0.90). Erythromycin and azithromycin appeared the most effective, with the number needed to treat ranging from four to seven. Quality of life was also significantly improved by prophylactic antibiotics (mean difference -1.55, 95% CI -2.59 to -0.51). Time to first exacerbation was prolonged in six studies, with one conflicting result. Neither the rate of hospitalization nor the rate of adverse events was significantly changed. Furthermore, no significant changes were observed in lung function, bacterial load and airway inflammation. However, antibiotic-resistant isolates were significantly increased (OR 4.49, 95% CI 2.48-8.12).Conclusions: Prophylactic antibiotics were effective in preventing COPD exacerbations and improving quality of life among stable patients with moderate to severe COPD. The choice of prophylactic antibiotics should be analysed and considered case by case, especially for long and continuous use.

U2 - 10.1093/jac/dky326

DO - 10.1093/jac/dky326

M3 - Article

C2 - 30189002

VL - 73

SP - 3231

EP - 3243

JO - Journal of Antimicrobial Chemotherapy

JF - Journal of Antimicrobial Chemotherapy

SN - 0305-7453

IS - 12

ER -

ID: 64680424