Do Antibiotics and Steroids Affect Mild-to-Moderate COPD Exacerbations?

Systemic corticosteroids and antibiotics benefit patients with severe exacerbations of chronic obstructive pulmonary disease (COPD), but whether benefits extend to patients with less-severe exacerbations is unclear. In a meta-analysis of 68 randomized, controlled trials (>10,000 patients), researchers assessed pharmacologic interventions in outpatients and inpatients with mild-to-moderate acute exacerbations of COPD. Excluded were studies of patients in intensive care units or patients receiving mechanical ventilation (including noninvasive) and non–English-language studies.

Compared with placebo, systemic corticosteroids were associated with significantly fewer treatment failures (number needed to treat, 3). Compared with placebo, antibioti…