COPD exacerbation

People living with COPD have a 'usual' level of breathlessness and cough they manage day to day. An exacerbation is when that baseline suddenly gets worse — more breathless, more cough, more or discoloured phlegm — over a short period, as if the disease has flared and the body cannot keep pace.

A COPD exacerbation is an acute worsening of respiratory symptoms beyond normal day-to-day variation that requires additional treatment. It is most often triggered by viral or bacterial respiratory infections, and sometimes by air pollution; the inflamed, narrowed airways trap even more air, worsening hyperinflation and the work of breathing. Treatment typically steps up bronchodilators, adds corticosteroids, and uses antibiotics when infection is likely, with oxygen or ventilatory support in severe cases.

Exacerbations matter far beyond the moment: they can require hospital admission, accelerate the long-term decline in lung function, and worsen quality of life and survival, especially when frequent. Much of COPD care is therefore aimed at preventing them — through inhaled therapy, vaccination, smoking cessation, and pulmonary rehabilitation — and at recognising and treating them early.