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The study recruited 311 consecutive patients with acute exacerbations of COPD over a five-year period from five Swiss teaching hospitals. All patients were older than 40 years of age, were currently smoking or have been smoking, smoking history ≥ 20 packets / year. All patients received 40 mg of methylprednisolone intravenously on day 1 and 40 mg / day of prednisone on day 2-5. After randomization, 155 patients were given oral prednisone 40 mg / d (routine treatment group) on day 6 to 14, and the remaining 156 patients received placebo (short-course treatment). Patients, caregivers, and researchers were unaware of the group.

All patients also received 7 days of broad-spectrum antibiotic therapy to prevent pneumonia, on-demand use of aerosolized short-acting bronchodilators, 2 inhaled corticosteroids and β-agonists on a daily basis Inhalation of tiotropium bromide(136310-93-5). Physiotherapy, oxygenation and ventilatory support are also recommended in accordance with the guidelines.

The median cumulative dose of prednisone was 200 mg and the mean cumulative dose was 379 mg for patients treated with short-term glucocorticosteroids, and 560 mg and 793 mg for patients receiving longer course of steroid therapy, respectively.

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