New COPD-X guidelines back oral steroids

REVISED COPD-X guidelines support the treatment of acute exacerbations of COPD with systemic glucocorticoids and antibiotics.

Dr Richard Wood-Baker, director of cardiorespiratory medicine at the Royal Hobart Hospital, said evidence to support the use of oral steroids has become more robust.

The latest advice from the Australian Lung Foundation and the Thoracic Society of Australia and New Zealand was that treatment with systemic glucocorticoids had the best outcomes associated with it, he said.

“Antibiotics used for all exacerbations have an overall benefit, although if we could identify the patients with bacterial infections that group would benefit most from oral antibiotics,” he said.

The majority of evidence on antibiotics comes from their use in hospital settings, but GPs have tended to use them as the first treatment, perhaps “seeing them as carrying less risk than oral corticosteroids”, he said.