The Discontinuation of Antibiotics in Patients with Chronic Obstructive Pulmonary Disease Exacerbation and a Positive Respiratory Viral Assay: A Single-center Retrospective Analysis

• Published in: Curēus (Palo Alto, CA) Vol. 11; no. 12; p. e6491
• Main Authors: Jiwa, Nasheena, Ibe, Uzochukwu, Beri, Rohit, Feinn, Richard
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 28-12-2019; Cureus
• Subjects: Antibiotics; Bacterial infections; Chronic obstructive pulmonary disease; Infections; Infectious Disease; Influenza; Internal Medicine; Pathogens; Patients; Pulmonology; Respiratory syncytial virus; Viral infections; Viruses; viral infections; acute exacerbation of copd; antibiotic stewardship; respiratory viral panel; respiratory infections
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.6491

Background The use of antibiotics in chronic obstructive pulmonary disorder (COPD) exacerbations attributed to viral infections is observed in this study. The aim of this analysis is to describe the rate of discontinuation of antibiotics in patients who have an acute exacerbation of COPD (AECOPD) caused by viral infections, in turn encouraging the use of the respiratory viral panel in an effort to improve antibiotic stewardship at our facility. Methods A retrospective chart review was performed. A total of 92 patients were analyzed who had a positive respiratory viral polymerase chain reaction (PCR) (RVP) admitted for COPD exacerbations, of which 20 patients had a bacterial co-infection by a sputum analysis. Patients with a positive infiltrate on chest X-ray (CXR) were excluded. The rate of discontinuation of antibiotics, excluding azithromycin and doxycycline, in patients with a positive RVP with and without a bacterial co-infection were analyzed. Results Of these 92 patients, we found that a bacterial co-infection was detected by sputum culture in 20 patients. The average number of days until discontinuation for patients with no bacterial coinfection was 1.67 days while for those with a bacterial co-infection was 3.20 days. The difference in the number of days was statistically significant (p<0.001). Conclusion In conclusion, patients with an identified viral etiology of COPD exacerbations had antibiotics discontinued significantly sooner than those patients with bacterial coinfections.