Acute exacerbation of chronic obstructive pulmonary disease

An acute exacerbation of chronic obstructive pulmonary disease (COPD) typically presents with an increased level of dyspnea, worsening of chronic cough, and/or an increase in the volume and/or purulence of the sputum produced.

An exacerbation may represent the first presentation of COPD, and COPD is usually associated with a history of tobacco exposure.

Treatment includes bronchodilators, systemic corticosteroids, oxygen, and antibiotics. Some patients with more severe exacerbations may require ventilatory support.

Antibiotics are reserved for exacerbations thought to be due to bacteria. An increase in sputum purulence, plus an increase in sputum volume, and/or increased dyspnea, indicates a need for antibiotics.

Treatment may be complicated by the development of hyperglycemia (associated with the use of corticosteroids) and/or diarrhea, including Clostridium difficile-associated diarrhea (associated with the use of antibiotics).

Chronic obstructive pulmonary disease (COPD) is "a common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases, and influenced by host factors, including abnormal lung development."[1]Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis and management of COPD (2022 report). Nov 2021 [internet publication]. https://goldcopd.org/wp-content/uploads/2021/11/GOLD-REPORT-2022-v1.1-22Nov2021_WMV.pdf

An exacerbation of COPD may be defined as "an acute worsening of respiratory symptoms that results in additional therapy."[1]Global Initiative for Chronic Obstructive Lung Disease. Global strategy for prevention, diagnosis and management of COPD (2022 report). Nov 2021 [internet publication]. https://goldcopd.org/wp-content/uploads/2021/11/GOLD-REPORT-2022-v1.1-22Nov2021_WMV.pdf