Corticosteroids in the management of acute exacerbations

Exacerbations of chronic obstructive pulmonary disease (COPD) have a major adverse impact on health status and place a serious burden on health care systems, particularly when they entail a visit to an emergency department or hospital admission (1). In 2000, COPD was responsible for 1.5 million emergency department visits and 726,000 hospitalizations in the United States (2). A hospital admission for COPD in the United States incurs average costs in excess of $16,000, so that hospitalization accounts for a large proportion of the total medical costs of caring for this disease (3,4). Because severe exacerbations are common, treatments that shorten their duration to even a small extent may provide substantial human and financial benefits in absolute terms.