Related Articles

Despite some limitations in current evidence, antibiotics appear to be beneficial for patients with acute exacerbations of chronic obstructive pulmonary disease, particularly those of higher severity. Methods

Data Sources

The Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, PsycINFO, and ClinicalTrials.gov were searched from inception to April 2012. Abstracts and references were reviewed, and trialists and pharmaceutical companies were contacted for unpublished data.

Study Selection

The authors included randomized controlled trials comparing any antibiotic with placebo for the treatment of acute exacerbations of chronic obstructive pulmonary disease. Studies of patients with asthma, acute bronchitis, pneumonia, or bronchiectasis were excluded.

Data Extraction and Synthesis

Two authors independently screened references and abstracted data. Quality of evidence was determined with domain-based and Grading of Recommendations Assessment, Development and Evaluation approaches. Heterogeneity was expressed with the I2 statistic. Pooled risk ratios, Peto odds ratios, and weighted mean differences were calculated with fixed-effect models. ...