Clinical Practice Guideline

COPD Exacerbation Management

(Developed by the AAFP, April 2021)

The guideline, Pharmacologic Management of COPD Exacerbations, was developed by the American Academy of Family Physicians and approved by the Board of Directors in April 2021. The guideline was then published in the American Family Physician.

Key Recommendations

Systemic antibiotics should be prescribed for adults with acute exacerbations of COPD to improve clinical cure and reduce clinical failure. Choice of antibiotic should be based on local resistance patterns, affordability, and patient history and preferences.
Systemic corticosteroids should be prescribed for adults with acute exacerbations of COPD to reduce clinical failure. There is insufficient evidence to guide the dose, route of administration, or duration of treatment.

The guideline panel also noted that short-acting bronchodilators are routinely used to improve symptoms in patients with acute exacerbations of COPD. See the full recommendation for additional information on implementation considerations and a summary of the evidence for other treatment options.

More About Practice Guidelines

These recommendations are provided only as assistance for physicians making clinical decisions regarding the care of their patients. As such, they cannot substitute for the individual judgment brought to each clinical situation by the patient's family physician. As with all clinical reference resources, they reflect the best understanding of the science of medicine at the time of publication, but they should be used with the clear understanding that continued research may result in new knowledge and recommendations. These recommendations are only one element in the complex process of improving the health of America. To be effective, the recommendations must be implemented.