COPD exacerbations are frequent events that have major short- and long-term impacts on both patients and society, making their treatment and prevention crucial issues. Recognising exacerbations in order to initiate early treatment is the first step of their management, followed by determining whether the patient can be managed at home or should be referred to the hospital. Exacerbation treatments rely on bronchodilators, antibiotics and corticosteroids, as well as oxygen therapy and ventilatory support if required. Prevention of exacerbations is based on pharmacological agents (mostly inhaled treatments, i.e. long-acting bronchodilators and corticosteroids) that should be prescribed gradually based on the patient's individualised categorisation, and on nonpharmacological measures, including smoking cessation, rehabilitation, education and integrated care. Efforts should also be directed at improving guideline implementation and standards of care in this area, to offer all patients a personalised approach.

Cite as: Roche N. COPD: treatment and prevention of pulmonary exacerbations. In: Burgel P-R, Contoli M, López-Campos JL, eds. Acute Exacerbations of Pulmonary Diseases (ERS Monograph). Sheffield, European Respiratory Society, 2017; pp. 147–166 [https://doi.org/10.1183/2312508X.10016516].