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Editorials |

Oral vs IV Corticosteroids for In-hospital Treatment of COPD Exacerbations

Donald P. Tashkin, MD, FCCP
Author and Funding Information

Affiliations: Los Angeles, CA ,  Dr. Taskin is Professor of Medicine, David Geffen School of Medicine at UCLA.

Correspondence to: Donald P. Tashkin, MD, FCCP, Professor of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Ave, Los Angeles, CA 90095-1690; e-mail: dtashkin@mednet.ucla.edu



Chest. 2007;132(6):1728-1729. doi:10.1378/chest.07-1622
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The clinical course of COPD is punctuated by acute exacerbations. These have been defined as “an event in the natural course of the disease characterized by a change in the patient’s baseline dyspnea, cough and/or sputum that is beyond normal day-to-day variation, is acute in onset and may warrant a change in regular medication …”1 The “worsening” symptoms are accompanied by variable decrements in lung function and worsening health status, with improvement in dyspnea and lung function generally within 1 to 2 weeks after initiation of treatment.2 However, the decline in health status may persist for months or even longer in cases of frequently recurring exacerbations,3 and frequent exacerbations may augment the accelerated rate of lung function decline that characterizes disease progression in COPD.4 While most patients with an acute exacerbation of COPD (AECOPD) are managed as outpatients, the treatment failure rate (requirement for intensification of therapy, unscheduled office or emergency department visits or hospitalization) is high, and epidemiologic studies5 indicate that 15 to 22% may require hospitalization.

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