The clinical course and antibacterial therapy for chronic obstructive lung disease associated with bronchiectasis

Aim: The aim of the study was to determine the peculiarities of clinical course and antibacterial therapy in patients with chronic obstructive pulmonary disease (COPD) associated with bronchiectasis at the stage of exacerbation. A total of 93 patients with stage II-IV COPD were examined. The clinical signs including external respiration tests, SatO 2, and blood gases were assessed. Multi-slice spiral computed tomography (MSCT) was performed in every patient. Resul 2ts: Based on MSCT data, bronchiectasis was found in 37.8% of patients with COPD. Frequent and severe exacerbations were characteristic of patients with COPD and bronchiectasis compared with patients without bronchiectasis. Pseudomonas aeruginosa was the most common pathogen (21.3%) in patients suffering from COPD with bronchiectasis. The most efficacious antibacterial therapy regimens for COPD associated with bronchiectasis were determined. Conclusions: (1) Severe and frequent exacerbations of COPD were typical for patients with undiagnosed bronchiectasis. These patients require administration of MSCT to detect bronchiectasis. (2) Antibacterial therapy by fluoroquinolones, cephalosporins, cephalosporins with antipseudomonal activity and their combinations is a reasonable choice for patients suffering from COPD with bronchiectasis considering high risk of pseudomonas aeruginosa infection. Inhibitor-protected aminopenicillins are efficacious in patients with COPD without bronchiectasis.