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ICS pneumonia risk in COPD — GPhC CRA MCQ

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ModerateRespiratory TherapeuticsICS pneumonia risk in COPDGPhC CRA

A 78-year-old woman with COPD uses salmeterol/fluticasone and tiotropium. She has had two pneumonias in 9 months and no eosinophil history is available. She asks whether inhaled steroid can cause chest infections. What is the most appropriate action?

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Correct answer: E — Advise that ICS can increase pneumonia risk in COPD and refer for regimen review

Inhaled corticosteroids in COPD can increase pneumonia risk, particularly in susceptible patients. Recurrent pneumonia warrants prescriber review of the ongoing risk-benefit balance and COPD phenotype. The patient should not independently stop a combination inhaler, because abrupt changes may worsen control and salmeterol monotherapy is not the intended product use. Tiotropium is a maintenance bronchodilator, not a reliever.

Reference: BNF; NICE CKS COPD