Placebo Versus Antibiotics in Acute Exacerbations of Chronic Obstructive Pulmonary Disease (COPD)

Inclusion Criteria: Acute exacerbation of COPD type I or II according to GOLD Ability to perform lung function tests Ability to take oral medication Exclusion Criteria: Pregnant or lactating women, or women of childbearing age not using an acceptable method of contraception. Pretreatment ( > 24 hours) with an antibiotic for the present exacerbation. Pretreatment with corticosteroids (>30 mg for more than 4 days) for the present exacerbation. Progression or new radiographic abnormalities on the chest X-ray. Severe exacerbation that required mechanical ventilation. History of bronchiectasis Recent or unresolved lung malignancy. Other disease likely to require antibiotic therapy. Significant gastrointestinal or other conditions that may affect study drug absorption. Class III or IV congestive heart failure or stroke. Immunodeficiency disorders such as AIDS, humoral immune defect, ciliary dysfunction etc. and the use of immunosuppressive drugs (>30 mg prednisolone maintenance dose or equivalent for more than 4 weeks). Cystic fibrosis Tuberculosis. Impaired renal function (creatinine clearance < 20 ml/min).