Segundo documento de consenso sobre uso de antimicrobianos en la exacerbación de la enfermedad pulmonar obstructiva crónica
Second consensus report on the use of antimicrobial agents in exacerbations of chronic obstructive pulmonary disease
F. Álvareza, E. Bouzab, J.A. García-Rodríguezb,
, J. Mensab, E. Monsóa, J.J. Picazob, V. Sobradilloa, A. Torresa, M. Moya Mirc, M. Martínez Ortiz de Záratec, F. Pérez Escanillad, T. Puentee, J.L. Cañadae
Corresponding author
jagarrod@gugu.usal.es
Correspondencia: Departamento de Microbiología. Hospital Universitario. P.° San Vicente 108. 37007 Salamanca. España
Correspondencia: Departamento de Microbiología. Hospital Universitario. P.° San Vicente 108. 37007 Salamanca. España
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"apellidos" => "Cañada" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] ] ] "afiliaciones" => array:5 [ 0 => array:3 [ "entidad" => "Sociedad Española de Neumología y Cirugía Torácica (SEPAR)" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Sociedad Española de Quimioterapia (Seq)" "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Sociedad Española de Medicina de Urgencias y Emergencias (Semes)" "etiqueta" => "<span class="elsevierStyleSup">c</span>" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Sociedad Española de Medicina General (Semg)" "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Sociedad Española de Medicina Rural y Generalista (Semergen)" "etiqueta" => "<span class="elsevierStyleSup">e</span>" "identificador" => "aff0025" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondencia: Departamento de Microbiología. Hospital Universitario. P.° San Vicente 108. 37007 Salamanca. España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Second consensus report on the use of antimicrobial agents in exacerbations of chronic obstructive pulmonary disease" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2003-03-18" "fechaAceptado" => "2003-03-18" "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En el año 2000, expertos de la Sociedad Española de Neumología y Cirugía Torácica (SEPAR), la Sociedad Española de Quimioterapia (SEQ) y la Sociedad Española de Medicina Familiar y Comunitaria (SEMFyC), conscientes de la importancia de la enfermedad pulmonar obstructiva crónica (EPOC), elaboraron un documento-consenso que pudiera servir como base para el control de la enfermedad, mediante un adecuado uso de antimicrobianos. Ahora, 3 años después, y con motivo de importantes avances científicos, se plantea una profunda revisión, que en realidad constituye el Segundo Documento de Consenso sobre Uso de antimicrobianos en la exacerbación de la enfermedad pulmonar obstructiva crónica. Por un lado, diferentes sociedades científicas han demostrado interés en adherirse al proyecto y trabajar en él: Sociedad Española de Medicina de Urgencias y Emergencias (SEMES), Sociedad Española de Medicina General (SEMG) y Sociedad Española de Medicina Rural y Generalista (SEMERGEN), lo cual, conjuntamente con la declinación de la SEMFyC, obliga a cambiar la estructura y algunos contenidos del documento. Por otra parte, en el momento presente se ha incorporado al arsenal terapéutico del médico un nuevo grupo de antimicrobianos (los cetólidos) con un único representante hasta ahora, la telitromicina, que permite considerarlo no sólo como terapia alternativa sino de elección, incluso en determinadas circunstancias clínicas que se analizan en el documento. Éstos son los dos aspectos más significativos que, sumados a otros, como la cada vez más aceptada actividad de levofloxacino sobre Pseudomonas aeruginosa y la constante actividad que demuestra amoxicilina-ácido clavulánico cuando se administra a las dosis recomendadas cada 8 horas, ofrecen nuevos patrones antibióticos para el tratamiento de esta enfermedad. Por último, se analizan científicamente otros grupos de antimicrobianos (macrólidos, cefalosporinas orales, etc.) y se ofrecen normas de empleo de estos agentes, tanto por parte de los especialistas como de los médicos de atención primaria</p>" ] "en" => array:1 [ "resumen" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Aware of the importance of chronic obstructive pulmonary disease (COPD), a panel of experts belonging to the Spanish Society of Respiratory Medicine and Thoracic Surgery (SEPAR), the Spanish Society of Chemotherapy (SEQ) and the Spanish Society of Family and Community Medicine (SEMFyC) issued a statement of consensus in 2000 to serve as the basis for adequate antibiotic control of the disease. Three years later, in accordance with significant scientific progress made in this area, the statement has been thoroughly revised. The new paper in fact constitutes a second consensus statement on the use of antibiotics in COPD exacerbations. When several scientific associations expressed interest in joining the project and contributing to it –the Spanish Society of Emergency Medicine (SEMES), the Spanish Society of General Medicine (SEMG) and the Spanish Society of Rural and General Medicine (SEMERGEN)– their incorporation led SEPAR and SEMFyC to change the structure of the statement and certain aspects of its content. Additionally, a new group of antibiotics, the ketolides, has joined the therapeutic arsenal. Telithromycin, the single representative of the group for the moment, can be considered not only an alternative treatment but even the drug of choice in certain clinical settings that are analyzed in the new statement. Those developments, along with others, such as the increasingly recognized action of levofloxacin against Pseudomonas aeruginosa and the steady action of amoxicillin with clavulanic acid when administered at recommended doses every 8 hours, provide new antimicrobial therapeutic protocols for COPD. Finally, the statement includes a scientific analysis of other groups of antimicrobial agents (macrolides, oral cephalosporins, etc.) and guidelines for both primary care physicians and specialists to follow when prescribing them</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:69 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The definition of emphysema: report of the National Heart and Blood Institute, division of lung diseases, workshop" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "G.L. Snider" 1 => "J. Kleinreman" 2 => "W.M. Thurlbeck" 3 => "Z.H. 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 3 | 3 | 6 |
| 2024 October | 38 | 23 | 61 |
| 2024 September | 40 | 16 | 56 |
| 2024 August | 45 | 31 | 76 |
| 2024 July | 38 | 27 | 65 |
| 2024 June | 51 | 19 | 70 |
| 2024 May | 40 | 20 | 60 |
| 2024 April | 34 | 24 | 58 |
| 2024 March | 38 | 23 | 61 |
| 2024 February | 40 | 30 | 70 |
| 2024 January | 0 | 4 | 4 |
| 2023 December | 0 | 7 | 7 |
| 2023 November | 0 | 4 | 4 |
| 2023 October | 0 | 11 | 11 |
| 2023 September | 0 | 5 | 5 |
| 2023 August | 0 | 2 | 2 |
| 2023 July | 0 | 1 | 1 |
| 2023 March | 3 | 5 | 8 |
| 2023 February | 39 | 34 | 73 |
| 2023 January | 44 | 25 | 69 |
| 2022 December | 49 | 33 | 82 |
| 2022 November | 52 | 24 | 76 |
| 2022 October | 68 | 35 | 103 |
| 2022 September | 71 | 26 | 97 |
| 2022 August | 69 | 37 | 106 |
| 2022 July | 55 | 44 | 99 |
| 2022 June | 26 | 29 | 55 |
| 2022 May | 56 | 48 | 104 |
| 2022 April | 42 | 18 | 60 |
| 2022 March | 31 | 38 | 69 |
| 2022 February | 21 | 25 | 46 |
| 2022 January | 31 | 19 | 50 |
| 2021 December | 20 | 43 | 63 |
| 2021 November | 17 | 44 | 61 |
| 2021 October | 20 | 58 | 78 |
| 2021 September | 22 | 52 | 74 |
| 2021 August | 10 | 36 | 46 |
| 2021 July | 14 | 35 | 49 |
| 2021 June | 18 | 40 | 58 |
| 2021 May | 15 | 27 | 42 |
| 2021 April | 21 | 53 | 74 |
| 2021 March | 26 | 44 | 70 |
| 2021 February | 30 | 16 | 46 |
| 2021 January | 19 | 33 | 52 |
| 2020 December | 23 | 24 | 47 |
| 2020 November | 8 | 13 | 21 |
| 2020 October | 22 | 12 | 34 |
| 2020 September | 13 | 6 | 19 |
| 2020 August | 22 | 9 | 31 |
| 2020 July | 32 | 29 | 61 |
| 2020 June | 14 | 11 | 25 |
| 2020 May | 20 | 14 | 34 |
| 2020 April | 24 | 10 | 34 |
| 2020 March | 20 | 21 | 41 |
| 2020 February | 25 | 27 | 52 |
| 2020 January | 26 | 33 | 59 |
| 2019 December | 29 | 30 | 59 |
| 2019 November | 15 | 8 | 23 |
| 2019 October | 30 | 24 | 54 |
| 2019 September | 13 | 17 | 30 |
| 2019 August | 22 | 12 | 34 |
| 2019 July | 19 | 15 | 34 |
| 2019 June | 13 | 5 | 18 |
| 2019 May | 39 | 24 | 63 |
| 2019 April | 37 | 13 | 50 |
| 2019 March | 10 | 17 | 27 |
| 2019 February | 8 | 11 | 19 |
| 2019 January | 5 | 3 | 8 |
| 2018 December | 11 | 12 | 23 |
| 2018 November | 18 | 21 | 39 |
| 2018 October | 41 | 26 | 67 |
| 2018 September | 13 | 11 | 24 |
| 2018 May | 6 | 1 | 7 |
| 2018 April | 8 | 7 | 15 |
| 2018 March | 3 | 7 | 10 |
| 2018 February | 17 | 13 | 30 |
| 2018 January | 5 | 7 | 12 |
| 2017 December | 6 | 15 | 21 |
| 2017 November | 5 | 6 | 11 |
| 2017 October | 5 | 12 | 17 |
| 2017 September | 9 | 11 | 20 |
| 2017 August | 11 | 18 | 29 |
| 2017 July | 11 | 15 | 26 |
| 2017 June | 27 | 20 | 47 |
| 2017 May | 10 | 7 | 17 |
| 2017 April | 6 | 3 | 9 |
| 2017 March | 7 | 23 | 30 |
| 2017 February | 6 | 8 | 14 |
| 2017 January | 8 | 8 | 16 |
| 2016 December | 22 | 10 | 32 |
| 2016 November | 21 | 16 | 37 |
| 2016 October | 12 | 18 | 30 |
| 2016 September | 18 | 25 | 43 |
| 2016 August | 17 | 10 | 27 |
| 2016 July | 20 | 10 | 30 |
| 2016 June | 24 | 10 | 34 |
| 2016 May | 21 | 6 | 27 |
| 2016 April | 12 | 4 | 16 |
| 2016 March | 12 | 1 | 13 |
| 2016 February | 11 | 4 | 15 |
| 2016 January | 20 | 10 | 30 |
| 2015 December | 40 | 16 | 56 |
| 2015 November | 30 | 6 | 36 |
| 2015 October | 61 | 1 | 62 |
| 2015 September | 50 | 0 | 50 |
| 2015 August | 46 | 0 | 46 |
| 2015 July | 43 | 0 | 43 |
| 2015 June | 51 | 0 | 51 |
| 2015 May | 53 | 0 | 53 |
| 2015 April | 47 | 0 | 47 |
| 2015 March | 40 | 0 | 40 |
| 2015 February | 27 | 0 | 27 |
| 2015 January | 32 | 0 | 32 |
| 2014 December | 41 | 0 | 41 |
| 2014 November | 37 | 0 | 37 |
| 2014 October | 53 | 0 | 53 |
| 2014 September | 44 | 0 | 44 |
| 2014 August | 44 | 0 | 44 |
| 2014 July | 39 | 0 | 39 |
| 2014 June | 57 | 0 | 57 |
| 2014 May | 64 | 0 | 64 |
| 2014 April | 67 | 0 | 67 |
| 2014 March | 58 | 0 | 58 |
| 2014 February | 61 | 0 | 61 |
| 2014 January | 45 | 0 | 45 |
| 2013 December | 54 | 0 | 54 |
| 2013 November | 50 | 0 | 50 |
| 2013 October | 59 | 0 | 59 |
| 2013 September | 54 | 0 | 54 |
| 2013 August | 67 | 0 | 67 |
| 2013 July | 72 | 0 | 72 |
| 2013 June | 43 | 0 | 43 |
| 2013 May | 28 | 0 | 28 |
| 2013 April | 27 | 0 | 27 |
| 2013 March | 11 | 0 | 11 |
| 2000 January | 7451 | 0 | 7451 |
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