14 June COPD

Teaching rounds today reviewed current data regarding treatment of COPD.  The case discussed was a patient who had been admitted for the first time with a COPD exacerbation.  Several recent studies have better defined the role of various treatments for this common and debilitating condition.

First: smoking cessation and long term oxygen therapy (when appropriate) remain the most beneficial treatments available. 

Second: tiotropium appears to be superior to ipratropium and has been shown to decrease mortality.

Third: antimicrobial therapy is beneficial in patients with moderate to severe exacerbations of COPD.  In general, having 2/3 or 3/3 of the following critieria indicate a moderate or severe exacerbations: increased sputum volume, increased sputum purulence, and increased dyspnea.

Fourth: Benefits of inhaled steroids are less clear for COPD, and when used should be limited to those with moderate to severe disease only.

The ACP In the Clinic series recently reviewed COPD and this article is a quick read that highlights the state of the art in COPD management.