Review article
Acute Exacerbations of Chronic Obstructive Pulmonary Disease - Guidelines and Rationale Antibiotic Treatment
Neven Rakušić
; Klinika za plućne bolesti Jordanovac
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the most prevalent diseases and the leading cause of disability and death worldwide. It is characterised by progressive airflow obstruction and punctuated by episodes of acute exacerbations. Exacerbations indicate instability or worsening of patient’s symptoms and clinical status of variable frequency and severity, and have been associated with the development of complications, reduced physical activity and health status, and an increased risk of death. Because of these negative consequences, prevention of exacerbations remains as a key goal of COPD management; proper and aggressive treatment is needed when exacerbations occur. Up to 75% of episodes of acute exacerbations usually have an infectious origin and are associated with increased inflammation of the upper and lower airways, and with systemic inflammation; most of them have a bacterial etiology, being of mixed viral infection in some cases. Exacerbations are classified as moderate, or severe if hospitalization ensues, with need for antibiotic treatment; and of the mild category with those episodes managed by patients themselves and no need for antibiotic. The guidelines for rationale antibiotic treatment of moderate and severe category of exacerbations are discussed and proposed to clinical practice.
Keywords
chronic obstructive pulmonary disease; exacerbation; infection; antibiotic treatment; guidelines
Hrčak ID:
111750
URI
Publication date:
5.11.2013.
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