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© 2007 The American Thoracic Society
doi: 10.1513/pats.200701-003FM
Exacerbations of Chronic Obstructive Pulmonary Disease
1 South Texas Veterans Health Care System, Audie L. Murphy Division, and the University of Texas Health Science Center at San Antonio, San Antonio, Texas; 2 State University of New York and Western New York Veterans Health Care System, Buffalo, New York; and 3 Division of Pulmonary and Critical Care Medicine at the University of Michigan, Ann Arbor, Michigan
Correspondence and requests for reprints should be addressed to Antonio Anzueto, M.D., Pulmonary/Critical Care (111E), University of Texas Health Science Center, 7400 Merton Minter Boulevard, San Antonio, TX 78229. E-mail: anzueto{at}uthscsa.edu
ABSTRACT
The diagnosis and treatment of acute exacerbations (AEs) of chronic obstructive pulmonary disease (COPD) is controversial. In this section, we review (1) the epidemiology of this condition; (2) the etiology—many patients with AECOPD are thought to have a combination of viral and bacterial infections, which contribute to their exacerbation. Bacterial organisms are isolated more commonly after viral infections in patients with COPD. The role that bacterial infections play in AECOPD remains a very controversial topic; (3) the use of diagnostic procedures; (4) efficacy of antibiotics; (5) clinical parameters to stratify patients' severity; (6) different groups of antibiotics that can be used; and (7) other therapies, including bronchodilators. We summarize the current literature, with special emphasis on the assessment of the long-term impact of this condition.
Key Words: acute exacerbations • antibiotics • chronic obstructive pulmonary disease • Haemophilus influenzae • Streptococcus pneumoniae
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