Systemic steroids in acute exacerbation of COPD - from guidelines to bedside.

The optimal steroid dosages in AECOPD are still under debate. Admission records of patients in our hospital from January to December 2008 due to a diagnosis of AECOPD were reviewed. More wheezing and tachypnea were noted in the patients with a maximal daily prednisolone dose more than 60 mg. The steroid dose was higher in AECOPD without pneumonia than those concurrent with pneumonia. Those who had concurrent pneumonia had a higher risk of nosocomial infections. The study reflects the heterogeneity of AECOPD and that steroid dosages were determined by the clinical evaluation of the severity of illness and bacterial infections.