Trial reportInfection2016
Determinants of bacteriological outcomes in exacerbations of chronic obstructive pulmonary disease.
Trial report in Infection, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
Who cites it
16 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Risk factors for Pseudomonas aeruginosa isolation in chronic obstructive pulmonary disease: a systematic review and meta-analysis.BMC pulmonary medicine · 2024Pooled it
- Bacterial infections in acute exacerbation of chronic obstructive pulmonary disease: a systematic review and meta-analysis.Infection · 2020Pooled it
- Dual roles of genes required for intrinsic resistance to clarithromycin in evasion of killing by serum complement inInfection and immunity · 2026Article
- COPD Exacerbation-Related Pathogens and Previous COPD Treatment.Journal of clinical medicine · 2022Article
- Decalogue for the selection of oral antibiotics for lower respiratory tract infections.Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2022Review
- The Impact of Chronic Bronchial Infection in COPD: A Proposal for Management.International journal of chronic obstructive pulmonary disease · 2022Review
- Ceftazidime-Avibactam-Based Versus Tigecycline-Based Regimen for the Treatment of Carbapenem-Resistant Klebsiella pneumoniae-Induced Pneumonia in Critically Ill Patients.Infectious diseases and therapy · 2021Article
- [Current microbiological aspects of community respiratory infection beyond COVID-19].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2021Review
- Antibiotic Retreatment for Acute Exacerbations of Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2020Article
- [Three keys to the appropriate choice of oral antibiotic treatment in the respiratory tract infections].Revista espanola de quimioterapia : publicacion oficial de la Sociedad Espanola de Quimioterapia · 2019Review
- Recognition of conserved antigens by Th17 cells provides broad protection against pulmonaryProceedings of the National Academy of Sciences of the United States of America · 2018Article
- A Prospective Study of Bacteriological Etiology in Hospitalized Acute Exacerbation of COPD Patients: Relationship with Lung Function and Respiratory Failure.Turkish thoracic journal · 2018Article
- Comparing microbiota profiles in induced and spontaneous sputum samples in COPD patients.Respiratory research · 2017Article
- Antibiotic de-escalation principle in elderly patients with chronic obstructive pulmonary disease complicated with severe pneumonia.Experimental and therapeutic medicine · 2017Article
- Bacteriological incidence in pneumonia patients with pulmonary emphysema: a bacterial floral analysis using the 16S ribosomal RNA gene in bronchoalveolar lavage fluid.International journal of chronic obstructive pulmonary disease · 2017Article
- Defining the Binding Region in Factor H to Develop a Therapeutic Factor H-Fc Fusion Protein against Non-Typeable Haemophilus influenzae.Frontiers in cellular and infection microbiology · 2016Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeChanges in sputum microbiology following antibiotic treatment of acute exacerbations of chronic obstructive pulmonary disease (AECOPD), including patterns of bacteriological relapse and superinfection are not well understood. Sputum microbiology at exacerbation is not routinely performed, but pathogen presence and species are determinants of outcomes. Therefore, we determined whether baseline clinical factors could predict the presence of bacterial pathogens at exacerbation. Bacterial eradication at end of treatment (EOT) is associated with clinical resolution of exacerbation. We determined the clinical, microbiological and therapeutic factors that were associated with bacteriological eradication in AECOPD at EOT and in the following 8 weeks.
methodsSputum bacteriological outcomes (i.e., eradication, persistence, superinfection, reinfection) from AECOPD patients (N = 1352) who were randomized to receive moxifloxacin or amoxicillin/clavulanate in the MAESTRAL study were compared. Independent predictors of bacterial presence in sputum at exacerbation and determinants for bacteriological eradication were analyzed by logistic regression and receiver operating characteristic (ROC) analyses.
resultsSignificantly greater bacteriological eradication with moxifloxacin was mainly driven by superior Haemophilus influenzae eradication (P = 0.002, EOT). Baseline clinical factors were a weak predictor of the presence of pathogens in sputum (AUCROC = 0.593). On multivariate analysis, poorer bacterial eradication was associated with antibiotic resistance (P = 0.0001), systemic steroid use (P = 0.0024) and presence of P. aeruginosa (P = 0.0282).
conclusionsSince clinical prediction of bacterial presence in sputum at AECOPD is poor, sputum microbiological analysis should be considered for guiding antibiotic therapy in moderate-to-severe AECOPD, particularly in those who received concomitant systemic corticosteroids or are at risk for infection with antibiotic-resistant bacteria.
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