ANTIBIOTIC TREATMENT AND BACTERIAL FLORA IN SPUTUM IN CHRONIC PULMONARY DISEASE EXACERBATIONS

Background and aims: A judicious use of antibiotics for Chronic Obstructive Pulmonary Disease (COPD) or asthma frequent exacerbation is a provocation for clinician. In this context, the aim of our study was to identify and describe the commonest bacterial pathogens and the preferred antibiotic for the treatment of the patients with recurrences for COPD and asthma exacerbations because this category of patients has worse health status and increased morbidity. Materials and methods: A retrospective study investigated patients with recurrent COPD or bronchial asthma, more than 2 exacerbations/ year and at least one early re-admission, admitted in Iasi University Clinical Hospital of Pulmonary Diseases from North- East Romania, from 2014 to 2019. Results: Only 33 patients were selected according to inclusion criteria. A small proportion of sputum culture identified the pathogen (20.35%) and most frequent were Streptococcus pneumoniae followed by Pseudomonas aeruginosa and Haemophilus influenzae. The bacteria identified were resistant to aminopenicillins and 1(st) - 3(rd) cephalosporins generation. Quinolones (levofloxacin) and colistin were the preferred antibiogram-based therapy. Conclusions: COPD and asthma exacerbation can be a start to antibiotic stewardship because these patients are the most exposed to inappropriate antibiotic use, decompensations, increased hospital stay, increased treatment costs.