PURLs

Steroids for Acute COPD—But for How Long?

Not only was a shorter course of glucocorticoid therapy as effective as a 14-day regimen, but there was no difference in the time to next exacerbation.

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PRACTICE CHANGER

Prescribe a five-day regimen of glucocorticoid therapy for acute exacerbations of chronic obstructive pulmonary disease (COPD); the shorter course of treatment appears to be as effective as a 14-day regimen.1

Strength of ­recommendation

B: Based on a single well-­designed randomized controlled trial (RCT).1

ILLUSTRATIVE CASE

A 55-year-old man with COPD presents to the emergency department (ED) with progressive shortness of breath, cough, and sputum production in the past four days. He is diagnosed with a COPD exacerbation, treated with corticosteroids, and admitted to the hospital. His inpatient treatment includes antibiotics, inhaled albuterol and ipratropium, supplemental oxygen, and oral corticosteroids.

How many days should he take oral steroids?

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