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Patients with chronic obstructive pulmonary disease (COPD) who are admitted for exacerbations usually are treated with antibiotics, although the evidence for this approach is weak. In addition, they often receive parenteral steroids, with doses equivalent to 600 mg of prednisone or more during their first few hospital days, despite contrary recommendations in major guidelines. These practices were examined in two large retrospective cohort studies, conducted by the same investigators and involving about 80,000 patients who were hospitalized with COPD exacerbations; patients admitted to intensive care units were excluded. The researchers used sophisticated statistical methods — including a technique known as propensity scoring — to control f…