The Role of Corticosteroids in Acute Exacerbations of Chronic Obstructive Pulmonary Disease

Chronic obstructive pulmonary disease (COPD) is an increasingly prevalent disease and is the fourth leading cause of death in the world today.¹ COPD is most commonly caused by smoking cigarettes, but is sometimes related to exposure to other toxic gases and chemicals. The defining characteristics of COPD are inflammation and damage to the lung tissue, with irreversible airflow impairment.² Of COPD exacerbations, approximately 50% to 70% are caused by bacterial infection. Other causes include viral infections and exposure to air pollutants; approximately one third of exacerbations have no known cause.³ Hospitalizations for COPD exacerbations are associated with high costs and poor outcomes. In addition, the overall mortality for patients admitted to the hospital for COPD exacerbations is high. Breen et al⁴ found that the mortality rate for patients admitted with COPD exacerbations was approximately 20% before hospital discharge, and the 3-year mortality rate of those discharged...