INTRODUCTION. The Global Initiative for Chronic Obstructive Lung Disease (GOLD), a report produced by the National Heart, Lung, and Blood Institute (NHLBI) and the World Health Organization (WHO), defines an exacerbation of chronic obstructive pulmonary disease (COPD) as "an acute event characterized by a worsening of the patient's respiratory symptoms that is beyond normal day-to-day In patients with COPD with a previous or recent history of exacerbations, we recommend education and case management that includes direct access to a health-care specialist at least monthly to prevent severe acute exacerbations of COPD, as assessed by decreases in hospitalizations (Grade 1C) . An exacerbation of chronic obstructive pulmonary disease (COPD) is defined as an acute event characterized by a worsening of the patient's respiratory symptoms et al. Physical activity in COPD patients decreases short-acting bronchodilator use and the number of exacerbations. Respir Med 2015; 109:1320. Au DH, Bryson CL, Chien JW, et al N-Acetylcysteine is recommended, with evidence grade 2B, by the American College of Chest Physicians guidelines for prevention of exacerbations in those with severe COPD and ≥2 exacerbations in 2 y. 6 But still, it is not widely used in the United States. This is an online decision support tool, specially developed to summarise COPD-X Guidelines, including a spirometry calculator and lung age estimator. This supports primary care practitioners in diagnosis and management of COPD. Endorsed by the following organisations according to their respective approved criteria: guidelines for the treatment of exacerbations have been promulgated by the global initiative for chronic obstructive lung disease (gold)5(table 1) as well as by the american thoracic society/european respiratory society6and the european national institute for health and care excellence.7although adjuncts to drug therapy, such as oxygen or … acute exacerbations of chronic obstructive pulmonary disease (aecopd) occur frequently in the course of copd. 1 they can differ in severity and many require hospitalisation, but the majority of This document provides clinical recommendations for treatment of chronic obstructive pulmonary disease (COPD) exacerbations. Comprehensive evidence syntheses, including meta-analyses, were performed to summarise all available evidence relevant to the Task Force's questions. The evidence was appraised using the Grading of Recommendations, Assessment, Development and Evaluation approach and the ALAT-2014 COPD Clinical Practice Guidelines used clinical questions in PICO format to compile evidence related to risk factors, COPD screening, disease prognosis, treatment and exacerbations. Evidence reveals the existence of risk factors for COPD other than tobacco, as well as gender differences in disease presentation. BACKGROUND:COPD is a major cause of morbidity and mortality in the United States as well as throughout the rest of the world. An exacerbation of COPD (periodic escalations of symptoms of cough, dyspnea, and sputum production) is a major contributor to worsening lung function, impairment in quality of life, need for urgent care or hospitalization, and cost of care in COPD. Research conducted Acute exacerbations of chronic obstructive pulmonary disease (COPD)—characterized by shortness of breath, increased sputum production, increased purulence, or a combination of these signs—are costly