Antibiotics or Placebo for Chronic Obstructive Pulmonary Disease

Excerpt

To the editor: In the february issue, anthonisen and colleagues (1) described a randomized, double-blinded, crossover trial of antibiotics or placebo in the treatment of exacerbations of chronic obstructive pulmonary disease. We congratulate them on a well-designed and conducted study that addresses a common clinical problem. Although well reported, however, their article raised several specific questions.

The authors discussed their criteria for the onset and resolution of exacerbations. We agree with their choice of patient symptoms and are encouraged by their kappa scores, which are consistently above 0.51 for the 3 key symptoms (increased dyspnea, increased sputum production, change in