Definition and aetiology of infective exacerbations of COPD

A standardised definition of infective exacerbation of chronic obstructive pulmonary disease (COPD) still represents an unmet need in respiratory medicine because it relies on clinical empiricism with little evidence-based scientific support. Infective exacerbations of COPD are certainly clear events in the mind of practising physicians. However, there is little consensus on their definition and relevance of different infective aetiologies. Indeed, the efforts to assess the efficacy of new therapies in the treatment and prevention of COPD exacerbations have been hampered by the lack of a widely agreed and consistently used definition. There is a strong need for greater investment in research on infective exacerbations of COPD in order to promote a better understanding and clinical approach of this event in the natural history of COPD. Herein we will review the current concepts, definitions and aetiology of the infective exacerbations of COPD, underlining their strength and limitations.