Diagnosis and Outpatient Management of Chronic Obstructive Pulmonary Disease: A Review

Methodology: 1/5 Usefulness: 2/5 Riley CM, et al. JAMA. 2019 Feb 26;321(8):786-797. Question: Aimed to review and provide practical information regarding the diagnosis and long-term management of patients with COPD in the outpatient setting. Methods: This was a systematic assessment where authors searched multiple sources and simply reviewed articles. Findings: They suggested the treatment of COPD should be done on a step-wise […]

C-Reactive Protein Testing to Guide Antibiotic Prescribing for COPD Exacerbations.

Methodology: 3/5 Usefulness: 2.5/5 Butler CC, et al. N Engl J Med. 2019 Jul 11;381(2):111-120 Editorial: COPD Exacerbations – A Target for Antibiotic Stewardship. Question and Methods: This was a multicenter RCT to determine if POCT CRP testing vs usual care may help safely reduce unnecessary use of antibiotics. Findings: Antibiotics were used in 57.0% (CRP) vs 77.4% (usual) of patients; adj. […]

CRP-guided antibiotic treatment in acute exacerbations of COPD in hospital admissions

Journal Club Summary Methodology Score: 2.5/5 Usefulness Score: 3/5 Prins HJ, et al. Eur Respir J. 2019 May 23;53(5).  Question and Methods: The CATCH Study was a multicentre, randomised, controlled open intervention clinical trial comparing CRP guided antibiotics for COPDE vs the Gold Strategy Findings: The study had a 14.5% AAR in antibiotic use within 24 hours with a NNT […]

Outpatient Management of Acute Exacerbations of COPD

In this post, we review an approach to antibiotics, bronchodilators, and corticosteroids in the outpatient management for acute exacerbations of COPD. COPD – The Basics What is it? An incompletely reversible obstructive lung disease due to airway and/or alveolar abnormalities leading to airflow limitation and persistent respiratory symptoms Caused by significant exposure to noxious particles or gases Most common – […]