Evidence map›Paper›PMID 33413341›Full record

ArticleRespiratory research2021

Antibiotic treatment in acute exacerbation of COPD: patient outcomes with amoxicillin vs. amoxicillin/clavulanic acid-data from 43,636 outpatients.

Kristian Bagge, Pradeesh Sivapalan, Josefin Eklöf, Frederik Böetius Hertz, Christian Østergaard Andersen, Ejvind Frausing Hansen, Jens Otto Jarløv, Jens-Ulrik Stæhr Jensen

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

Article in Respiratory research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.9field-weighted citation impact, top 26% 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

2 citing papers in PubMed, 7 citations in OpenAlex.

  1. Article
  2. Article
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

8 authors at 2 institutions in 1 country.

Kristian BaggeDepartment of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark. work@kristianbagge.com.ORCID http://orcid.org/0000-0002-7078-4002
Pradeesh SivapalanDepartment of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark.
Josefin EklöfDepartment of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark.
Frederik Böetius HertzDepartment of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Christian Østergaard AndersenDepartment of Clinical Microbiology, Hvidovre Hospital, University of Copenhagen, Kettegård Alle 30, 2650, Hvidovre, Denmark.
Ejvind Frausing HansenDepartment of Internal Medicine, Respiratory Medicine Section, Hvidovre Hospital, University of Copenhagen, Hvidovre, Denmark.
Jens Otto JarløvDepartment of Clinical Microbiology, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
Jens-Ulrik Stæhr JensenDepartment of Internal Medicine, Respiratory Medicine Section, Herlev and Gentofte Hospital, Copenhagen University Hospital, Hellerup, Denmark.
University of Copenhagen · DKGentofte Hospital · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundFor antibiotic treatment of Acute exacerbations of COPD (AECOPD) the National guidelines in Denmark recommend either first choice amoxicillin 750 mg TID (AMX) or amoxicillin with clavulanic acid 500 mg/125 mg TID (AMC). Addition of clavulanic acid offers a broader spectrum; opposite, AMX alone in a higher dose may offer more time above MIC. The aim of this study was to determine which of these regimens is associated with better outcome.

methodsThe Danish Registry of COPD (DrCOPD), a nationwide outpatient COPD registry, was crosslinked with medication data and hospital contacts. The first prescription of AMX or AMC after inclusion in DrCOPD was used as exposure variable. Adjusted Cox proportional hazards models were used to analyze the risk of hospitalization or death (combined) within 30 days and other endpoints.

resultsFor the first treatment of AECOPD 12,915 received AMX, and 30,721 patients received AMC. AMX was associated with a decreased risk of pneumonia hospitalization or death (aHR 0.6, 95% CI 0.5-0.7; p < 0.0001) compared to AMC.

conclusionIn AECOPD, empirically adding clavulanic acid to amoxicillin is not associated with a better outcome; it seems safe for these patients to be treated with amoxicillin alone.

Indexed as

Data AnalysisDisease ProgressionAgedAged, 80 and overAmbulatory CareAmoxicillinAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial AgentsCohort StudiesDenmarkFemaleHumansMaleMiddle AgedPulmonary Disease, Chronic ObstructiveRetrospective StudiesAmoxicillinAmoxicillin-Potassium Clavulanate CombinationAnti-Bacterial Agents

Identifiers

PMID33413341
PMCPMC7789423
OpenAlexW3120299119

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Registered trials

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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.