Canadian guidelines for the management of acute exacerbations of chronic bronchitis

Area of Science:

• Pulmonology
• Infectious Diseases
• Microbiology

Background:

• Acute exacerbations of chronic bronchitis (AECB) are a significant cause of morbidity and mortality in Canada, leading to over 1.5 million physician visits annually.
• Existing Canadian guidelines for AECB require updating to reflect current medical knowledge and practices.

Framework:

• This document is a collaborative effort by respirologists, microbiologists, infectious disease specialists, and family physicians.
• Treatment recommendations are graded based on the strength of available scientific evidence.

Implementation:

• The role of oral corticosteroid therapy in managing AECB is examined for preventing treatment failures, accelerating recovery, and delaying subsequent exacerbations.
• Patient risk stratification based on factors predicting treatment failure is proposed to guide antibiotic selection.

Implications:

• The guidelines address the growing concern of antimicrobial resistance to existing antibiotics.
• Strategies for preventing future AECB episodes are suggested to reduce disease burden.