Purulent sputum predictive of bacterial infection in COPD

Sputum that looks purulent has been confirmed as a good predictor of bacterial infection in patients with an exacerbation of chronic obstructive pulmonary disease (COPD) requiring admission to hospital. Forty such patients were admitted and had bronchoscopy; 17 of the 22 who had purulent sputum had a positive culture from uncontaminated specimens obtained with bronchoscopy, but only 1 of 18 who had mucoid sputum had a positive culture.

Other factors predicting bacterial positivity included previous admissions, more than four exacerbations annually, and severe airflow obstruction. The authors suggest that these simple variables may help to predict which patients should be given antibiotics.