ABSTRACT
An acute exacerbation is defined as a transient increase in symptoms which is acute in onset. It is usually triggered by viral infection, or more rarely by bacterial infection. Exacerbation frequency is an indicator of decline in lung function. Most patients with severe chronic obstructive pulmonary disease have two to three exacerbations per year. The common symptoms of exacerbation include the following: increasing cough, increasing sputum, increasing breathlessness, a change in the colour of the sputum, and general malaise. The following steps have been shown to reduce the incidence of exacerbation. These are long-acting bronchodilators, inhaled corticosteroids, mucolytic agents–these can reduce cough and sputum tenacity and reduce exacerbation by 30%, education and a self-management plan, pulmonary rehabilitation and vaccinations. Establish the patient on optimal therapy and arrange multi-disciplinary assessment if necessary. Exacerbation frequency is a major determinant of decline in lung function.
