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COPD inhaled corticosteroid pneumonia risk — GPhC CRA MCQ

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HardRespiratory TherapeuticsCOPD inhaled corticosteroid pneumonia riskGPhC CRA

A 74-year-old patient with COPD is on triple therapy including an inhaled corticosteroid. He has had two pneumonias this year and few eosinophils on recent blood tests. What is the most appropriate action?

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Correct answer: B — Suggest prescriber review of the inhaled corticosteroid component

Inhaled corticosteroids can increase pneumonia risk in COPD, and benefit varies with exacerbation history and eosinophil count. Recurrent pneumonia should prompt review of whether the ICS remains appropriate. Maintenance oral corticosteroids are generally avoided due to systemic harm. Bronchodilator maintenance should not be stopped without clinical review.

Reference: NICE CKS; BNF