The Truth About Antibiotics and COPD

COPD is a chronic lung disease characterized by a predisposition to recurrent COPD exacerbations, some of which are complicated by lung infections. However, the exact role of bacterial, viral, or other infections in COPD is not always clear.

Antibiotics are prescription medications used to treat bacterial infections in the body. Bacterial infections often require treatment because they may not resolve on their own. These medications can be beneficial for treating and preventing infections associated with COPD, but they can cause side effects. Experts suggest that antibiotics may be overused in COPD, and strategies are emerging for optimizing the use of antibiotics so that people living with COPD will be prescribed an antibiotic only in situations when it would be beneficial.

Antibiotics and COPD Exacerbations

Antibiotics can be effective for treating your COPD exacerbation, but only if you have a bacterial infection. By definition, these medications are designed to destroy bacteria. Your medical team can identify bacteria with a sputum sample, and they may also consider some of the signs that suggest that you could have a bacterial infection, including:

• An increase in dyspnea, cough, and/or purulent sputum
• Severe exacerbations requiring non-invasive or mechanical ventilation

Prophylactic Treatment With Antibiotics

Over the years, the practice of using prophylactic antibiotics to prevent COPD exacerbation has been a matter of controversy. Research studies using azithromycin and erythromycin show that prophylactic antibiotics can reduce exacerbations.

But research also suggests that prophylactic antibiotics are associated with negative side effects that can sometimes outweigh the benefits, such as antibiotic resistance.

To date, the European Respiratory Society/American Thoracic Society guideline does not recommend the daily use of antibiotics for the treatment of COPD, except in cases of bacterial infection associated with COPD exacerbation.

Tips for Taking Your Antibiotics

If you have COPD, antibiotics certainly have a possible role in your medical treatment, but they are not useful in every situation. Your medical team will have to consider the specifics of your condition when deciding if you need antibiotic treatment and which antibiotic would be best for you.

If you are prescribed a prophylactic antibiotic, pay careful attention to the possible side effects and tell your healthcare provider right away if you think you may be experiencing any adverse effects of your medication.

Here's how to get the maximum benefit out of the medication:

• Remember that antibiotics are ineffective in treating infections caused by a virus, such as the common cold or flu. So do not take any "extra" antibiotic that you have sitting around at home when you start to feel sick at a later time.
• Never take anybody else's antibiotics. Because each antibiotic targets certain bacteria, you can never assume that someone's medication will work for your particular illness.
• Take the entire course of antibiotics as prescribed, even if you start to feel better. Stopping too soon may lead to a worsening of your condition because it will only be partially treated.
• Excessive use of antibiotics can increase the risk of antibiotic resistance, which is a condition in which bacterial infection does not improve with standard antibiotic therapy.
• Be sure to read the prescription bottle carefully and follow the directions. If you don't understand the instructions or the drug label, talk to your healthcare provider or pharmacist.
• Follow your healthcare provider's instructions, which should be printed on your prescription. Your instructions will be individualized, possibly based on certain factors, such as your weight, your overall health, and the other medications that you take.
• Ask your healthcare provider about how to deal with side effects such as nausea and diarrhea.
• Be mindful of any precautionary labels attached to the prescription bottle. For example, a label might advise to avoid sunlight or drink lots of water during antibiotic therapy.
• Ask your healthcare provider or pharmacist if you should take your antibiotic with food or on an empty stomach. This information should also be included in the drug's labeling.
• If you are a woman, talk to your healthcare provider about the increased risk of developing a yeast infection during antibiotic therapy and what you can do to prevent and recognize it.