What are the recommended first-line treatments for a patient diagnosed with COPD exacerbation in primary care?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 14 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

First-line treatments for a COPD exacerbation in primary care include increasing the doses or frequency of short-acting bronchodilators, using the same delivery system as usual, such as inhalers, spacers, or nebulizers, depending on the patient's ability and resources available .

If there are no contraindications, consider prescribing a short course of oral corticosteroids, typically 30 mg of prednisolone once daily for 5 days .

Additionally, if the patient has a significant increase in breathlessness that interferes with daily activities, oral corticosteroids should be considered .

Oxygen therapy should be administered cautiously, targeting appropriate saturation levels, and pulse oximetry should be used to guide therapy .

Educational content only. Always verify information and use clinical judgement.