Table 3 Proposed goals of treatment of chronic obstructive pulmonary disease exacerbation

Clinical resolution to baseline

Needs baseline assessment prior to exacerbation onset for comparison

Prevention of relapse

Relapse within 30 days is quite frequent

Increasing exacerbation-free interval

Needs long-term follow-up after treatment

Faster resolution of symptoms

Needs validated symptom assessment tools

Preservation of health-related quality of life

Sustained decrements seen after exacerbations

Bacterial eradication

Often presumed in usual antibiotic comparison studies

Resolution of airway inflammation

Shown to be incomplete if bacteria persist

Resolution of systemic inflammation

Persistence of systemic inflammation predicts early relapse

Restoration of lung function to baseline

Incomplete recovery is seen in significant proportion

Preservation of lung function

Needs long-term studies