Evidence supports the use of antibiotics and systemic corticosteroids for treating patients with mild to severe exacerbations of chronic obstructive pulmonary disease, say US researchers.

Researchers from Mayo Clinic, in Minnesota, evaluated the comparative effectiveness and adverse events of pharmacological interventions for adults with exacerbation of COPD in their systematic review of 68 randomised controlled trials that included 10,758 participants.

In the short term (at the end of the intervention), compared with placebo or management without intervention, antibiotics for 3-14 days were associated with double the odds of exacerbation resolution and 46% lower odds of treatment failure compared with placebo.

Systemic corticosteroids for 9-56 days were associated with 99% lower odds of treatment failure, compared with placebo, independent of exacerbation severity and study setting, the authors wrote in the Annals of Internal Medicine.