Letters

Management of chronic obstructive pulmonary disease

BMJ 2003; 326 doi: http://dx.doi.org/10.1136/bmj.326.7393.821 (Published 12 April 2003) Cite this as: BMJ 2003;326:821

Statement about theophyllines is misleading

  1. B Ronan O'Driscoll, consultant respiratory physician ([email protected])
  1. Hope Hospital, Salford M6 8HD
  2. Southampton General Hospital, Southampton SO16 6YD
  3. St Mary's Hospital, Portsmouth PO3 6AD

    EDITOR—The editorial by Babu and Chauhan on the management of acute exacerbations of chronic obstructive pulmonary disease contains a serious error of fact. The Cochrane review by Barr et al is quoted to support their proposal that standard treatment for exacerbations of chronic obstructive pulmonary disease should include theophyllines.1 This review said no such thing.

    The reviewers' conclusions were that there is no evidence to support the routine use of methyl-xanthines for exacerbations of chronic obstructive pulmonary disease. Methyl-xanthines do not appreciably improve forced expiratory volume in one second (FEV1) during exacerbations, and cause adverse effects; evidence of their effect on admissions is limited.2

    Although theophyllines were used by previous generations of doctors for managing acute …

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