Does low antibiotic consumption influence microbiological findings in patients with COPD exacerbations?
Abstract number: o225
Harboe Z.B., Wandall J.H., Knudsen J.D.
Chronic Obstructive Pulmonary Disease (COPD) is a frequent cause of hospital admission. Antibiotic use is being recognized as the main factor for development of resistance. The Danish outpatient antibiotic consumption is low (14 DDD/1000 inh.-days) compared to most countries in Europe (2030 DDD/1000 inh.-days). The objective was to describe the epidemiology of microbiological findings from COPD patients admitted with exacerbations (COPD-ptt), and relate that to the efficacy of empiric first-line treatments.
Retrospective study of all COPD-ptt admitted to three Internal Medicine wards and an ICU in 2003, identified through a hospital database. Sputum samples were spontaneously expectorated or sucked for standard microbiological analysis. Data were analysed by SPSS software. Survival was assessed by Kaplan-Meier test. P-values < 0.05 were considered significant.
340 COPD-ptt in 560 admissions were included, from a population of app. 90,000 inhabitants. Sputum samples from 176 ptt (52 %) were obtained. The three months-mortality was 16 %; 19 % for ptt with findings in sputum, 9 % for ptt with negative samples (p = 0.11). Potentially pathogenic microorganism (PPM) grew in 113 samples (51 %) from 99 ptt (56 %), 88 samples (40 %) did not have PPM growth and 19 samples (9 %) were not suitable for analysis. The findings for COPD-ptt were S. pneumoniae 18%; H. influenzae 13 %; P. aureuginosa 13 %; Candida spp. 14% and others PPM penicillin-resistent in 32% of ptt. This is similar to findings reported in the rest of Europe. Administration of i.v. penicillin was sufficient in only 49 % of admissions with positive findings.
Low antibiotic consumption does not influence microbiological findings in COPD-ptt, compared to high-consumptions settings. Penicillin is not sufficient as first-line treatment, as it is recommended.
|Session name:||XXIst ISTH Congress|
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