Use of antibiotics in elderly patients with exacerbated COPD: The OLD-chronic obstructive pulmonary disease study

Raffaele Antonelli Incalzi, Andrea Corsonello, Claudio Pedone, Giulio Masotti, Franco Rengo, Vittorio Grassi, Vincenzo Bellia

Research output: Contribution to journalArticle

Abstract

OBJECTIVES: To verify how frequently geriatric patients hospitalized for exacerbated chronic obstructive pulmonary disorder (COPD) had not been given antibiotics at home and to identify the relationship between the patient's condition and the prescribing practice. DESIGN: Observational study. SETTING: General medicine acute care wards. PARTICIPANTS: Four hundred fifty-nine elderly patients admitted to the hospital because of exacerbated COPD. MEASUREMENTS: Indices of severity of COPD exacerbation, such as age, St. George Respiratory Questionnaire (SGRQ) score, number of exacerbations in the previous year, and Cumulative Illness Rating Scale score were considered in the analyses. RESULTS: Ninety (19.6%) patients had an antibiotic prescribed before admission. The prescription was not associated with older age and was weakly associated with greater comorbidity. Having more than four exacerbations (odds ratio (OR)=2.16, 95% confidence interval (CI)=1.27-3.66) and a SGRQ symptoms subscore greater than 70 (OR=1.61, 95% CI=1.0-2.68) were independent correlates of the use of antibiotics before admission, although 67% of patients reporting more than four exacerbations in the previous year and 73.1% of patients with a SGRQ symptoms subscore greater than 70 had not been given any antibiotic prescription at home. CONCLUSION: The majority of older patients hospitalized for exacerbated COPD had not been given antibiotics at home, although they had at least one index of exacerbation severity.

Original languageEnglish
Pages (from-to)642-647
Number of pages6
JournalJournal of the American Geriatrics Society
Volume54
Issue number4
DOIs
Publication statusPublished - Apr 2006

Keywords

  • Antibiotic
  • Comorbidity
  • COPD exacerbation
  • Elderly
  • St. George Respiratory Questionnaire

ASJC Scopus subject areas

  • Geriatrics and Gerontology

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