Prospective randomized study |
Inclusion of large numbers of COPD patients |
Clear definition of AECB (criteria of Anthonisen et al. 19?) |
Consider chronic COPD treatment (corticosteroids, mucolytic agents, bronchodilators, physical therapy) |
Consider delay of prior antibiotic treatment |
Determine subgroups of patients |
Severity of COPD |
Severity of AECB |
Number of exacerbation in the past year |
Comorbidity factors (cardiovascular or renal diseases, smoking, alcoholism) |
Define parameters |
Clinical |
Functional |
Bacteriological (Gram stain and culture with quantitative analysis) |
Biological (CRP, leukocytosis, etc.) |
Establish short-and long-term evaluation during follow-up |
Use standardized antibiotic treatment (first- and second-line) |
Use standardized additional treatment |
Evaluation of compliance with treatment |
Evaluation of quality-of-life score using questionnaire |
Evaluation of economic impact of both disease and treatment |
Criteria for hospitalization and discharge |
COPD: chronic obstructive pulmonary disease
CRP: C-reactive protein