Abstract
An exacerbation, a key clinical feature of chronic obstructive pulmonary disease (COPD), is characterized by an acute increase in patient symptoms during the course of their stable disease. It is crucial to treat this situation which is considered to be one of the most important markers of severity as well as of prognosis of this disease. By using multiple questionnaires in the national hospital network of respiratory diseases in Kyushu area, we investigated how pulmonologists manage these catastrophes in outpatient as well as in hospital. As a result, we found a considerable variation among them in terms of pharmacologic therapy. Short-acting beta2-agonists (SABA) were used variously from every 20 minutes to every 12 hours for mild exacerbations and from every 10 minutes to every 6 hours for severe ones. Systemic steroids were differently administered in doses of 10mg/day of prednisolone to more than 30mg/day for three days to over seven days in outpatient situations. They were injected in drip infusion for three to 14 days in hospitalized patients. Oral antibiotics were given for less than 5 days and up to 14 days in outpatients. Parenteral antibiotics were injected for 7 to 14 days. The optimal doses, frequency, and duration of these treatments remains uncertain. These results might be derived from the heterogeneous pathogenesis of exacerbations of this disease. Further studies are needed to determine the proper use of these drugs.
