Diagnosis and Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Points

• More than 1.7 million patients per year present to the emergency department requiring treatment for chronic obstructive pulmonary disease (COPD), with about 20% requiring inpatient hospitalization. This costs the United States, directly and indirectly, between $35 and $50 billion each year.
• The GOLD guidelines, updated in 2016, contain a consensus definition for acute exacerbation of COPD, risk assessment, and evidence-based man-agement strategies.
• In patients with purulent sputum, a short course of antibiotics is warranted. Community-acquired pathogens include Haemophilus influenzae, Streptococcus pneumoniae, and Moraxella catarrhalis. In critically ill patients, Pseudomonas and methicillin-resistant Staphylococcus aureus (MRSA) are more common, and antibiotic regimens should be tailored to cover those pathogens as well.

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