Summary

• May represent the first presentation of COPD, usually associated with a history of tobacco exposure.
• Typically presents with an increased level of dyspnoea, worsening of chronic cough, and/or an increase in the volume and/or purulence of the sputum produced.
• Treatment includes bronchodilators, systemic corticosteroids, and antibiotics.
• Antibiotics may be reserved for exacerbations thought to be due to bacteria. An acute change in the volume and colour of sputum produced is suggestive of a bacterial trigger.
• Treatment may be complicated by the development of hyperglycaemia (associated with the use of corticosteroids) and/or diarrhoea, including Clostridium difficile-associated diarrhoea (associated with the use of antibiotics).