BACKGROUND: Long-term antibiotic therapy is used to prevent exacerbations of @entity1030 but there is uncertainty over whether this reduces airway bacteria. The optimum antibiotic choice remains unknown. We conducted an exploratory trial in stable @entity1 with @entity1030 comparing three antibiotic regimens against placebo. METHODS: This was a single-centre, single-blind, randomised placebo-controlled trial. @entity1 aged >= 45   years with @entity1030 , FEV1<80% predicted and chronic productive cough were randomised to receive either @entity3477 400   mg daily for 5   days every 4   weeks, @entity3403 100   mg/day, @entity4580 250   mg 3 times a week or one placebo tablet daily for 13   weeks. The primary outcome was the change in total cultured bacterial load in sputum from baseline; secondary outcomes included bacterial load by 16S quantitative PCR (qPCR), sputum @entity32 and antibiotic resistance. RESULTS: 99 @entity1 were randomised; 86 completed follow-up, were able to expectorate sputum and were analysed. After adjustment, there was a non-significant reduction in bacterial load of 0.42 log10   cfu/mL (95% CI -0.08  to 0.91, p=0.10) with @entity3477 , 0.11 (-0.33 to 0.55, p=0.62) with @entity3403 and 0.08 (-0.38 to 0.54, p=0.73) with @entity4580 from placebo, respectively. There were also no significant changes in bacterial load measured by 16S qPCR or in airway @entity32 . More treatment-related adverse events occurred with @entity3477 . Of note, mean inhibitory concentrations of cultured isolates increased by at least three times over placebo in all treatment arms. CONCLUSIONS: Total airway bacterial load did not decrease significantly after 3   months of antibiotic therapy. Large increases in antibiotic resistance were seen in all treatment groups and this has important implications for future studies. TRIAL REGISTRATION NUMBER: clinicaltrials.gov (NCT01398072).

Effects of different antibiotic classes on airway bacteria in stable XXXX using culture and molecular techniques: a randomised controlled trial.

@entity1 :: ('9606', 'Species') :: ['Patients', 'patients'] @entity32 :: ('MESH:D007249', 'Disease') :: ['inflammation'] @entity3477 :: ('MESH:C104727', 'Chemical') :: ['moxifloxacin'] @entity3403 :: ('MESH:D004318', 'Chemical') :: ['doxycycline'] @entity4580 :: ('MESH:D017963', 'Chemical') :: ['azithromycin'] @entity1030 :: ('MESH:D029424', 'Disease') :: ['COPD']
@entity1030 :: (MESH:D029424,Disease) :: ['COPD']
