Die akute Exazerbation der COPD: Was gibt es Neues? - Wissenszuwachs sinnvoll in der Praxis eingesetzt

In den letzten Jahren hat es einen wesentlichen Wissenszuwachs bei akuten Exazerbationen der chronisch obstruktiven Lungenerkrankung (AE-COPD) gegeben. Ihre Definition ist klarer geworden und kann in der klinischen Praxis sinnvoll eingesetzt werden. Die Rolle von Atemwegsviren als Auslöser einer AE-COPD ist zunehmend deutlicher geworden und es werden laufend noch neue Atemwegsviren identifiziert. Die Bedeutung der Bakterien ist schon länger bekannt, wobei aktuell vor allem Risikofaktoren für eine bakterielle Genese besser erkannt werden und somit die Antibiotikatherapie effizienter eingesetzt werden kann. Die antientzündliche Therapie kann aufgrund aktueller Ergebnisse sinnvoller und differenzierter eingesetzt werden und seit kurzem liegen auch Daten zu prophylaktischen Maßnahmen vor, wobei der Grippeschutzimpfung die wichtigste Rolle zukommt. Es bleibt abzuwarten, inwieweit diese neuen Erkenntnisse zu einer Verminderung der Morbidität und Mortalität der AE-COPD führen werden.

The knowledge about acute COPD exacerbations (AE-COPD) has grown tremendously within the last years. The definition of AE-COPD has become clearer and can be used expediently in clinical practice. The role of respiratory viruses as triggers of AE-COPD has become more definite and new emerging respiratory viruses are being identified. The importance of bacteria has been known for a longer time but recently clinical risk factors associated with detection of bacteria have been acknowledged allowing a more efficient use of antibiotics. The anti-inflammatory treatment can be employed more sensible and differentiated on the basis of recent data. Prophylactic measures, mainly the flu vaccination, have been shown to be important. Time will tell whether these new findings will help to reduce morbidity and mortality of AE-COPD

Key words

Acute COPD exacerbations (AE-COPD) - respiratory viruses and bacteria - antibiotics - anti-inflammatory treatment - flu vaccination

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