Acute worsening of patient's respiratory symptoms beyond normal day-to-day variations that results in additional therapy in patients with underlying chronic obstructive pulmonary disease (COPD)
COPD refers to a group of diseases that block airflow and impair breathing and includes emphysema and chronic bronchitis
Recent and sustained worsening of dyspnea and cough with increased sputum production compared to the baseline in a patient with COPD
Important: Symptoms can overlap with pneumonia (pneumonia more likely if tachycardia, tachypnea at rest and crepitations that persist after coughing are present)
Usually not needed but to be considered in severe cases; the respiratory tract of people with COPD may be colonized with bacteria (e.g. Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, Pseudomonas aeruginosa, Stenotrophomonas maltophilia) and a positive culture may indicate colonization rather than acute infection
Consider C-reactive protein and/or procalcitonin, complete blood count, and blood pH and gases
Consider a chest radiograph in patients requiring hospitalization to exclude other diagnoses and in outpatients if pneumonia suspected
Recommend smoking cessation, reduced indoor air pollution, use of long-acting inhaled β₂-agonists (± anticholinergics) and vaccination (e.g. against influenza, Streptococcus pneumoniae and SARS-CoV-2)
Antibiotics are not needed for most cases
Please check regularly for updates