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. 2020 May 28;9(6):1639. doi: 10.3390/jcm9061639

Figure 1.

Figure 1

Areas of controversy about long-term antibiotic therapy in COPD. AE: Acute exacerbation, AB: antibiotic therapy (Continuous line: AB1; short dotted line: AB2; long dotted line: AB3); C: cure; Horizontal dotted/dashed line: clinical threshold within certain limits of variability according to modifying factors (horizontal continuous lines). Under AB therapy, the concentration of PPM decreases, and when the threshold is crossed again, the clinical symptoms disappear (cure). When the intensity and speed of the bactericidal activity of the AB is increased, recovery occurs more rapidly, and the time to the next exacerbation (horizontal arrow) is lengthened. AB activity produces a “fall” in bacterial concentrations, which, if not completely eradicated after the pressure of the antimicrobial agent is removed, “rise” again. Reproduced with permission of the © ERS 2020. European Respiratory Journal 20 (36 suppl) 9s–19s; DOI: 10.1183/09031936.02.00400302 Published 1 July 2002.