The effectiveness and adverse events (AEs) of drug treatment for adults with exacerbations of chronic obstructive pulmonary disease (COPD) has now been assessed in a systematic review and meta-analysis of 68 randomised controlled trials. Antibiotic use for 3-14 days was linked to improved resolution of exacerbation (odds ratio [OR], 2.03; 95% CI, 1.47-2.80) and reduced treatment failure (OR, 0.54; CI, 0.34-0.86) following the intervention, when compared with placebo therapies or management without antibiotics.  Systemic corticosteroid use for 9-56 days was also linked to reduced treatment failure following the intervention (OR, 0.01; CI, 0.00-0.13), but were associated with an increased number of all-cause and endocrine-related AEs. Although antibiotics and systemic corticosteroids were found to reduce treatment failure in adults with exacerbation of COPD, the meta-analysis identified potential bias and poor reporting of AEs in numerous studies and could not draw further conclusions on the effectiveness of other commonly used pharmacologic interventions such as aminophyllines and inhaled corticosteroids. The study, recently published in the Annals of Internal Medicine, can be viewed here.

Contributed by Australian Medication Safety Services Associate – Isabella Singh