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Table 3 Proposed goals of treatment of chronic obstructive pulmonary disease exacerbation

From: The problems of meta-analysis for antibiotic treatment of chronic obstructive pulmonary disease, a heterogeneous disease: a commentary on Puhan et al

Goals Comments
Clinical resolution to baseline Needs baseline assessment prior to exacerbation onset for comparison
Prevention of relapse Relapse within 30 days is quite frequent
Increasing exacerbation-free interval Needs long-term follow-up after treatment
Faster resolution of symptoms Needs validated symptom assessment tools
Preservation of health-related quality of life Sustained decrements seen after exacerbations
Bacterial eradication Often presumed in usual antibiotic comparison studies
Resolution of airway inflammation Shown to be incomplete if bacteria persist
Resolution of systemic inflammation Persistence of systemic inflammation predicts early relapse
Restoration of lung function to baseline Incomplete recovery is seen in significant proportion
Preservation of lung function Needs long-term studies