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Systemic Corticosteroid and Antibiotic Use in Hospitalized Patients With Chronic Obstructive Pulmonary Disease
Sarah E Petite1, Julie A Murphy1
11 University of Toledo, OH, USA.
The Annals of Pharmacotherapy
|September 4, 2018
Summary
Standard-dose systemic corticosteroids shortened hospital stays for COPD exacerbation patients. Guideline-recommended therapies did not significantly impact readmission rates or length of stay for antibiotics.
Area of Science:
- Pulmonology
- Internal Medicine
- Pharmacology
Background:
- Effective management of chronic obstructive pulmonary disease (COPD) exacerbations is crucial for healthcare resource optimization.
- The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines offer recommendations for systemic corticosteroid and antibiotic use in select COPD exacerbation patients.
Purpose of the Study:
- To assess the clinical impact of GOLD guideline-recommended systemic corticosteroid and antibiotic therapy in hospitalized COPD exacerbation patients.
- Evaluate effects on readmission rates and hospital length of stay.
Main Methods:
- Retrospective, single-center, noninterventional study of adult inpatients with documented COPD exacerbation.
- Two analyses were performed: one for systemic corticosteroid dosing (standard vs. high-dose) and one for antibiotic use (appropriate vs. inappropriate).
Main Results:
- Standard-dose systemic corticosteroids (≤200 mg PEs) were associated with a significantly shorter hospital length of stay (LOS) compared to high-dose therapy (3 days vs. 4 days).
- No significant differences in 30-day readmission rates were observed between standard and high-dose corticosteroid groups (20.5% vs. 13.1%).
- Neither appropriate nor inappropriate antibiotic use showed significant differences in 30-day readmission rates or hospital LOS.
Conclusions:
- Standard-dose systemic corticosteroid therapy was linked to reduced hospital LOS in COPD exacerbation management.
- No significant clinical outcome differences were found between appropriate and inappropriate antibiotic use.
- Guideline-recommended systemic corticosteroid and antibiotic therapy is advised for hospitalized COPD exacerbation patients.
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