[Treatment of COPD (excluding acute distress)]

There is no available drug which has been demonstrated to reverse the pathological lesions associated with chronic obstructive pulmonary disease, either at the bronchial or at the parenchymal level. Bronchodilators may improve dyspnea and exercise tolerance; in some patients, they may also decrease moderately airflow obstruction. Their benefit on the rate of decline of forced expiratory volume in one second has not been documented. In the same way, the regular use of inhaled steroids has not been shown to prevent or limit the degradation of pulmonary function. On the other hand, long term oxygen supply improves the life expectancy of patients with chronic hypoxemia. Antibiotic treatment of exacerbations is recommended; however, the rationale for its use is still a matter of debate.