Are inhaled corticosteroids increasing the “load” for some patients with COPD?

The clinical burden of chronic obstructive pulmonary disease (COPD) remains one of the most significant unmet needs not only in respiratory medicine but in global health [1, 2]. Despite drives to improve diagnosis rates, encourage smoking cessation and improve function with pulmonary rehabilitation and prescription of inhaled therapies, impacts on quality of life and healthcare resources continue to place an unacceptable load on both patients and health services [1]. A key driver for this health burden is acute exacerbations, which continue to affect a patient's health even after optimal medical management is in place [1]. Inhaled corticosteroids cause increases in sputum bacterial load in COPD patients with lower eosinophil levels