A possible, long-term prophylactic effect of antibiotics given to patients with acute exacerbations of chronic obstructive pulmonary disease (COPD) in the outpatient setting has been investigated in a randomised controlled trial.¹ Although antibiotics are recommended for some patients for the management of acute exacerbations, systematic reviews and clinical trials have shown conflicting results.^2–4 Results of studies that have examined the effect of antibiotics have been inconsistent.⁴ There is evidence demonstrating that antibiotics result in some short-term improvement in patients who are …