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Current Challenges in Chronic Bronchial Infection in Patients with Chronic Obstructive Pulmonary Disease

Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, 41013 Seville, Spain
CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, 28029 Madrid, Spain
Pneumology Department, Hospital Universitari Vall d’Hebron/Vall d’Hebron Institut de Recerca (VHIR), Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
Pneumology Department, Hospital de la Santa Creu i Sant Pau, 08041 Barcelona, Spain
Servicio de Microbiología, Hospital Universitario Ramón y Cajal and Instituto Ramón y Cajal de Investigación Sanitaria (IRYCIS), 28034 Madrid, Spain
Pneumology, Hospital Arnau de Villanova-Lliria, 46015 Valencia, Spain
Pneumology Department, Universitary and Polytechnic La Fe Hospital, 46015 Valencia, Spain
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(6), 1639;
Received: 30 April 2020 / Revised: 21 May 2020 / Accepted: 22 May 2020 / Published: 28 May 2020
Currently, chronic obstructive pulmonary disease (COPD) patients and their physicians face a number of significant clinical challenges, one of which is the high degree of uncertainty related to chronic bronchial infection (CBI). By reviewing the current literature, several challenges can be identified, which should be considered as goals for research. One of these is to establish the bases for identifying the biological and clinical implications of the presence of potentially pathogenic microorganisms in the airways that should be more clearly elucidated according to the COPD phenotype. Another urgent area of research is the role of long-term preventive antibiotics. Clinical trials need to be carried out with inhaled antibiotic therapy to help clarify the profile of those antibiotics. The role of inhaled corticosteroids in patients with COPD and CBI needs to be studied to instruct the clinical management of these patients. Finally, it should be explored and confirmed whether a suitable antimicrobial treatment during exacerbations may contribute to breaking the vicious circle of CBI in COPD. The present review addresses the current state of the art in these areas to provide evidence which will enable us to progressively plan better healthcare for these patients. View Full-Text
Keywords: COPD; potentially pathogenic microorganism; chronic bronchial infection COPD; potentially pathogenic microorganism; chronic bronchial infection
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MDPI and ACS Style

Lopez-Campos, J.L.; Miravitlles, M.; de la Rosa Carrillo, D.; Cantón, R.; Soler-Cataluña, J.J.; Martinez-Garcia, M.A. Current Challenges in Chronic Bronchial Infection in Patients with Chronic Obstructive Pulmonary Disease. J. Clin. Med. 2020, 9, 1639.

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