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 – […]

Short-term vs Conventional Glucocorticoid Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease The REDUCE Randomized Clinical Trial

Journal Club Summary Methodology Score: 4/5                 Usefulness Score: 4/5 Leuppi JD, et al. JAMA. 2013 Jun 5;309(21):2223-31. Article Link   This multicenter, double blinded trial demonstrated non-inferiority of a 5-day course of 40mg prednisone versus a 14-day course of 40mg prednisone in the treatment of patients admitted to hospital for acute exacerbation of COPD (AECOPD). Although the patient population was not […]

Short-term vs Conventional Glucocorticoid Therapy in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: the REDUCE randomized clinical trial

Journal Club Summary Methodology Score: 4/5                 Usefulness Score: 3.5/5   Leuppi JD, Schuetz P, Bingisser R, Bodmer M, Briel M, Drescher T, et al. JAMA. 2013 Jun 5;309(21):2223-31 Article Link   This multicentre, Swiss-based RCT adds to the literature that suggests a short course (5days) of glucocorticoid is as effective as a longer course (14 days) for the inpatient COPD […]