Role of infection and antimicrobial therapy in acute exacerbations of chronic obstructive pulmonary disease

Expert Rev Anti Infect Ther. 2006 Feb;4(1):101-24. doi: 10.1586/14787210.4.1.101.


Over the past several years, the significance of acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in patients with chronic airflow obstruction has become increasingly apparent due to the impact these episodes have on the natural history of disease. It is now known that frequent AECOPD can adversely affect a patient's health-related quality of life and short- and long-term pulmonary function. The economic burden of these episodes is also substantial. AECOPDs represent a local and systemic inflammatory response to both infectious and noninfectious stimuli, but the majority of episodes are likely related to bacterial or viral pathogens. Patients with purulent sputum and multiple symptoms are the most likely to benefit from treatment with antibiotics. Antibiotic choice should be tailored to the individual patient, taking into account the severity of the episode and host factors which might increase the likelihood of treatment failure. Current evidence suggests that therapeutic goals not only include resolution of the acute episode, but also prolonging the time to the next event. In the future, preventing exacerbations will likely become increasingly accepted as an additional therapeutic goal in chronic obstructive pulmonary disease patients.

Publication types

  • Review

MeSH terms

  • Anti-Infective Agents / therapeutic use*
  • Bacterial Infections / complications*
  • Bacterial Infections / drug therapy
  • Bacterial Infections / microbiology
  • Clinical Trials as Topic
  • Humans
  • Pulmonary Disease, Chronic Obstructive / complications*
  • Pulmonary Disease, Chronic Obstructive / drug therapy
  • Pulmonary Disease, Chronic Obstructive / immunology
  • Pulmonary Disease, Chronic Obstructive / physiopathology*
  • Virus Diseases / complications*
  • Virus Diseases / drug therapy
  • Virus Diseases / microbiology


  • Anti-Infective Agents