Although the role of respiratory infection in COPD is
well documented, there is a paucity of data regarding the
eff ects of inhaled corticosteroids on infection in COPD.
Chronic bacterial infection is common in COPD and
contributes to worse clinical outcomes.96 Two studies96,97
using sputum cultures found no association between
inhaled corticosteroid use and bacterial infection, but in a
study54 using quantitative PCR, higher doses of inhaled
corticosteroids were associated with greater bacterial loads.