The use of the Prospector calculator reduces antibiotic therapy in exacerbations of chronic obstructive pulmonary disease

Chronic obstructive pulmonary disease (COPD) exacerbations frequently cause patient consultations in both out- and inpatient settings. Recent data suggest that only 40–60% of exacerbations are of bacterial origin and mandate antibiotic treatment. However, a reliable tool to justify prescribing antibiotics for COPD exacerbation is still lacking. This study was designed to explore the hypothesis that utilization of a novel decision-making tool called Prospector would lead to lower consumption of antibiotics and provide a more rational approach to managing COPD exacerbations versus standard therapy in patients with COPD. The study included 77 COPD patients who experienced a COPD exacerbation and were treated in outpatient settings. The Prospector group (PG) ( n = 40) were treated by the study author using the Prospector calculator (a tool designed by the first author that translates: patient symptoms, exacerbation, and medical history of COPD into a decision on the use of antibiotics in COPD exacerbation treatment). Other primary care specialists treated the control group (CG) ( n = 37) in the same outpatient clinic; antibiotic therapies were implemented at the physician’s discretion, most often using Anthonisen’s criteria. All other medications were administered at the physician’s discretion. Safety endpoints were set as: death, hospitalization, and number of exacerbations. Antibiotics were administered in 32.8% and 81.2% of exacerbations in the PG and CG, respectively ( p