Document Type

Article

Original Publication Date

2012

Journal/Book/Conference Title

The New England Journal of Medicine

Volume

367

DOI of Original Publication

10.1056/NEJMct1115170

Comments

Originally Published at http://dx.doi.org/10.1056/NEJMct1115170

Date of Submission

January 2015

Abstract

An estimated 24 million persons in the United States have COPD on the basis of lung-function testing.1 Globally, COPD is the fourth leading cause of death,2 and in the United States it is the third most common cause of death and chronic complications.3 The average person with COPD has one to two acute exacerbations each year, with wide variation from patient to patient.4 In 2000 in the United States, 726,000 patients were hospitalized with acute exacerbations of COPD.1 During an acute exacerbation, antibiotics are generally administered for 5 to 10 days,5 creating a national burden of 120 million to 480 million antibiotic-days annually. The median hospital stay per exacerbation has been estimated at 9 days.6 In a 2007 Canadian study, the median cost of a hospital stay after an acute exacerbation of COPD was $9,557 (Canadian dollars).7 Acute exacerbations of COPD requiring hospitalization are associated with a 30-day rate of death from any cause of 4 to 30%.6 A study in Sweden showed an all-cause mortality of 26% at 30 days and of 69% at 3 years.8 Acute exacerbations also accelerate the progressive decline in lung function associated with COPD. Overall, the FEV1 falls by approximately 33 ml per year in patients with COPD.4 Each acute exacerbation increases the rate of decline by an additional 2 ml per year4 and by up to 7 ml per year in smokers.6

Rights

From The New England Journal of Medicine, Wenzel, R. P., Fowler, A. A., Edmond, M. B., Antibiotic Prevention of Acute Exacerbations of COPD, Vol. 367, Page 340, Copyright © 2012 Massachusetts Medical Society.

Is Part Of

VCU Medical Center Publications

Share

COinS