Abstract
OBJECTIVE: To find scientific evidence to support the indication for treating outbreaks in COPD patients on an out-patient basis with levofloxacine, as against conventional treatments. DESIGN: Standardised review, following the criteria of medicine based on the evidence. A bibliographic search of the MEDLINE data base from 1966 to June 2000 was the basis for an analysis of the evidence found. SETTING: Non-hospital treatment. PATIENTS AND OTHER PARTICIPANTS: COPD patients suffering a light outbreak of probable bacterial origin, according to the Anthonisen criteria. INTERVENTIONS: The intervention analysed was treatment with 500 mg/day of levofloxacine taken orally. An attempt was made to compare this with conventional treatments such as amoxycillin-clavulanic acid and acetyl cefuroxime. The indicators of results analysed were reduction in mortality or in the number of hospital admissions. MEASUREMENTS AND MAIN RESULTS: No clinical trial was found that compared levofloxacine and amoxycillin-clavulanic acid. Two clinical trials were found that compared levofloxacine and acetyl cefuroxime. These found no significant differences between the group treated with levofloxacine and the group treated with cefuroxime. CONCLUSIONS: No scientific evidence demonstrating advantages of levofloxacine treatment over amoxycillin-clavulanic acid was found, or over acetyl cefuroxime as empirical PC first-choice treatment for patients with outbreaks of COPD.