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  • Q&A with Australian Health Practitioners

    Why is the use of antibiotics for COPD exacerbation controversial?

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    Dr Samantha Herath

    Respiratory & Sleep Medicine Physician

    Dr Samantha Herath completed her Respiratory and Sleep Medicine training in New Zealand, Australia and Canada. She has extensive post-fellowship, sub-speciality training in Sleep Medicine … View Profile

    COPD or Chronic Obstructive Airways Disease can commonly present with a cough, shortness of breath or wheeze in isolation or in any combination. In early stages of COPD, the patient may be asymptomatic as well.

    Flare up of these symptoms is called an exacerbation of COPD. It is important to remember that COPD can be exacerbated by infective as well as non-infective causes.Even when an exacerbation or a flare up is due to an infective cause, it could be a viral infection or bacterial infection driven.

    Antibiotics are effective essentially during exacerbations secondary to bacterial infections. 

    The danger in prescribing antibiotics without a clear indication can lead to the development of resistant bacteria or also known as "superbugs". Infections with these organisms are very difficult to treat. Therefore, care must be taken when prescribing antibiotics to make sure it is really indicated.Also, antibiotics have their share of side effects. It could be a minor rash leading to very serious conditions.

    Therefore, in summary, antibiotics do have a role in treating COPD exacerbations due to infections. Irresponsible use of antibiotics could lead to the development of antibiotic resistance. However, if recurrent infections are

    However, if recurrent infections are occurring in COPD patients they should be screened with a high resolution CT scan of the chest for a condition called bronchiactasis.

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