Which treatment is appropriate for a COPD exacerbation?

• A. Oral antibiotics for all
• B. Systemic corticosteroids plus short-acting bronchodilators
• C. Immediate intubation for all
• D. Antibiotics only if fever present

Answer: (B)

In a COPD flare, the goal is to rapidly reduce airway inflammation and relieve bronchospasm to improve breathing. Systemic corticosteroids do this by decreasing airway inflammation, speeding recovery, and shortening hospital stay. Pairing them with short-acting bronchodilators quickly opens the airways and eases dyspnea. Antibiotics aren’t needed for every exacerbation; they’re added only when there’s evidence of bacterial infection, such as increased sputum purulence or volume and signs of infection. Immediate intubation isn’t indicated for all patients—it’s reserved for those with respiratory failure or inability to protect the airway. So the best initial treatment combines systemic corticosteroids with short-acting bronchodilators.