A 68-year-old man with COPD presents with increased dyspnea and purulent sputum production. What is initial management?

• A. Antibiotics only
• B. Systemic corticosteroids and short-acting bronchodilators
• C. Inhaled corticosteroids only
• D. Oxygen therapy only

Answer: (B)

Managing an acute COPD exacerbation focuses on quickly reducing airway inflammation and relieving bronchospasm. Systemic corticosteroids help shorten the course of the flare, improve lung function, and speed recovery, while short-acting bronchodilators rapidly relieve bronchoconstriction and dyspnea. This combination addresses the core acute issues driving the patient’s worsening symptoms.

Oxygen therapy is important if there is hypoxemia, but on its own it does not treat the underlying airway inflammation or bronchospasm. Antibiotics are considered when there are signs of a bacterial infection, such as purulent sputum, but the initial, fastest-acting management centers on steroids plus bronchodilators. Inhaled corticosteroids alone don’t provide rapid relief of acute symptoms.