Evidence map›Paper›PMID 25767383›Full record

ArticleInternational journal of chronic obstructive pulmonary disease2015

Amoxicillin concentrations in relation to beta-lactamase activity in sputum during exacerbations of chronic obstructive pulmonary disease.

Marjolein Brusse-Keizer, Paul VanderValk, Rogier W van der Zanden, Lars Nijdam, Job van der Palen, Ron Hendrix, Kris Movig

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
0.5field-weighted citation impact, top 29% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 5 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Marjolein Brusse-KeizerMedical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands.
Paul VanderValkDepartment of Pulmonary Medicine, Medisch Spectrum Twente, Enschede, the Netherlands.
Rogier W van der ZandenDepartment of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, the Netherlands.
Lars NijdamDepartment of Clinical Pharmacy, Medisch Spectrum Twente, the Netherlands.
Job van der PalenMedical School Twente, Medisch Spectrum Twente, Enschede, the Netherlands ; Department of Research Methodology, Measurement and Data Analysis, University of Twente, the Netherlands.
Ron HendrixRegional Laboratory of Public Health, Enschede, the Netherlands ; Department of Medical Microbiology, University Medical Centre Groningen, and University of Groningen, Groningen, the Netherlands.
Kris MovigDepartment of Clinical Pharmacy, Medisch Spectrum Twente, the Netherlands.
Medisch Spectrum Twente · NLMaastricht University Medical Centre · NLUniversity of Groningen · NLUniversity of Twente · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAcute exacerbations of chronic obstructive pulmonary disease (COPD) are often treated with antibiotics. Theoretically, to be maximally effective, the antibiotic concentration at sites of infection should exceed the minimum inhibitory concentration at which 90% of the growth of potential pathogens is inhibited (MIC90). A previous study showed that most hospitalized COPD patients had sputum amoxicillin concentrations <LMIC90 when treated with amoxicillin/clavulanic acid. Those with adequate sputum concentrations had better clinical outcomes. Low amoxicillin concentrations can be caused by beta-lactamase activity in the lungs. This study investigated whether patients with sputum amoxicillin concentrations <MIC90 had higher beta-lactamase activity in sputum than patients with a concentration ≥MIC90.

methodsIn total, 23 patients hospitalized for acute exacerbations of COPD and treated with amoxicillin/clavulanic acid were included. Sputum and serum samples were collected at day 3 of treatment to determine beta-lactamase activity in sputum and amoxicillin concentrations in both sputum and serum.

resultsWe found no difference in beta-lactamase activity between patients with sputum amoxicillin concentrations <MIC90 and ≥MIC90 (P=0.79). Multivariate logistic regression analysis showed no significant relationship between beta-lactamase activity and sputum amoxicillin concentrations <MIC90 or ≥MIC90 (odds ratio 0.53; 95% confidence interval 0.23-1.2; P=0.13). Amoxicillin concentrations were <MIC90 in 78% of sputum samples and in 30% of serum samples.

conclusionIn patients treated with amoxicillin/clavulanic acid for an acute exacerbation of COPD, sputum beta-lactamase activity did not differ between those with sputum amoxicillin concentrations <MIC90 or ≥MIC90. The finding that the majority of patients had sputum amoxicillin concentrations <MIC90 suggests that current treatment with antibiotics for acute exacerbations of COPD should be optimized.

Indexed as

AgedAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial Agentsbeta-LactamasesChi-Square DistributionDisease ProgressionDrug MonitoringFemaleHospitalizationHumansLogistic ModelsMaleMicrobial Sensitivity TestsMiddle AgedMultivariate AnalysisProspective StudiesAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial Agentsbeta-Lactamasesamoxicillinchronic obstructive pulmonary diseaseclavulanic acidconcentrationexacerbationMIC90

Identifiers

PMID25767383
PMCPMC4354398
OpenAlexW2165195455

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.