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Chronic Obstructive Pulmonary Disease: Role of Bacteria and Updated Guide to Antibacterial Selection in the Older Patient
Drugs & Aging, 11/25/09
Parameswaran I et al. – Use of antibacterials, based on current susceptibility patterns, is beneficial in patients with severe COPD experiencing exacerbations and in patients with severe exacerbations. Antibacterial susceptibility patterns among the bacterial pathogens are evolving, and knowledge of local susceptibility patterns is useful in antibacterial selection. Penicillin, amoxicillin, cotrimoxazole (trimethoprim/sulfamethoxazole) and doxycycline should not be used as an initial antibacterial because of resistance patterns. The authors recommend second–/third–generation cephalosporins, amoxicillin/clavulanic acid, azithromycin and respiratory fluoroquinolones as initial choices. In patients at risk of colonization by, and infection as a result of, P. aeruginosa, ciprofloxacin, levofloxacin or an advanced penicillin/penicillinase combination effective against this species should be used. Drug–drug interactions should be considered in antibacterial choice.
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