How effective are prophylactic antibiotics for patients with chronic obstructive pulmonary disease (COPD)?
All trials of continuous antibiotics used macrolides. The trials included patients who had frequent exacerbations and needed treatment with antibiotics or systemic steroids, or who were on supplemental oxygen. It is not clear from the studies the extent to which participants had other treatments for their COPD optimised (eg, smoking cessation programmes, pulmonary rehabilitation, vaccination).
People with COPD may have exacerbations that usually occur after respiratory infections. These may lead to further irreversible loss of lung function with days off work, hospital admission, reduction in quality of life and even death.