Table 3. Use of antibiotics in COPD exacerbations.

COPD: chronic obstructive pulmonary disease; N/A: not available; mg: miligrams

Author	Year	Type Of Study	Drug	Dose and Route of Administration	Course of treatment	Clinical Use	Effect on Hospital Stay / Re-admission	Effect of Mortality	Adverse Effects
Mihaela S. Stefan MD et al. [64]	2012	Retrospective cohort study	Quinolone and macrolide + cephalosporin macrolide monotherapy	N/A	Two days	Acute exacerbations of COPD	13% decrease in readmission	40% decrease in mortality	Clostridium difficile colitis
Hammad Qureshi et al. [59]	2014	Randomized controlled trial.	Macrolides & B-lactam agents (should be combined with B-lactam inhibitors), Fluoroquinolones, and Tobramycin	Oral and inhaled	< Five days	For normal exacerbations, severe exacerbations, history of antibiotic use, and history of oral corticosteroid use. Efficient against resistant strains of Haemophilus influenzae and Streptococcus pneumoniae. Severe COPD with colonization of Pseudomonas. Decreases sputum inflammatory markers and colonies of bacteria.	N/A	N/A	N/A
MeiLan K. Han et al. [65]	2014	Randomized controlled trial	Azithromycin	250 mg	Daily for one year	Most effective in preventing acute exacerbations in patients requiring systemic steroids and antibiotics. The most significant advantage was seen in older patients. No benefit for current smokers was seen.	N/A	N/A	Minor hearing loss and nasopharyngeal colonization with azithromycin-resistant organisms.
Patricia van Velzen MD et al. [66]	2017	Randomized double-blind placebo-controlled trial	Doxycycline	Oral 100 mg daily and 200 mg on the first day	Seven-day course	COPD exacerbations in the outpatient department	No significant effect	No significant effect	N/A
A.J. Reis et al. [63]	2018	Narrative review.	Aminopenicillin with clavulanic acid, a macrolide, or a tetracycline.	N/A	Five to seven days	COPD exacerbations	N/A	N/A	Long-term use of macrolides may lead to the risk of developing bacterial resistance.