Doxycycline add on benefits elderly patients with COPD

Although bacteria contribute significantly to acute exacerbations of chronic obstructive pulmonary disease (AECOPD), the added value of antibiotics remains controversial, especially in outpatient settings. 

The researchers conducted a study to analyse the effect of doxycycline addition for Acute exacerbation of COPD using real-world evidence. They found that in elderly patients with COPD, doxycycline added on to corticosteroid reduces treatment failure (acute exacerbation; AECOPD) by 23% in the short term (15-31 days of initiation). However, no reductions were seen in this population in the long term (approximately 12 months) or in all-ages analyses.

A retrospective cohort study of pharmacy claims for 6300 adult primary care outpatients in the Netherlands who received either doxycycline (n=2261) or no antibiotic (n=4039) added on to corticosteroid (40 mg daily for 5 days or 30 mg daily for 7 days). The primary outcome was treatment failure, Acute exacerbation of COPD in the short- and long-term.

. The researchers found no difference between doxycycline and no-antibiotic groups in short-term risk for treatment failure across all age groups combined. However, an older subgroup (aged 75+ years) had a 23% reduced risk for treatment failure with add-on doxycycline:16.1% vs 19.9% in no-antibiotic group.Adjusted OR, 0.77 (95% CI, 0.62-0.97).