COPD Exacerbations — A Target for Antibiotic Stewardship

Abstract

Patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) in whom outpatient treatment fails are at risk for serious decompensation and hospitalization. Thus, when outpatients with COPD present with acutely worsening symptoms, clinicians are tempted to err on the side of doing more, which usually entails prescribing both oral glucocorticoids and antibiotics. However, not all acute exacerbations are provoked by respiratory tract infection, and of those that are, it is difficult to distinguish whether viruses or bacteria are responsible. The dilemma is to identify patients who are most likely to benefit from antibiotics while avoiding unnecessary antibiotic use. Antibiotic . . .