Systemic corticosteroids are recommended for patients admitted with AECOPD, with benefits including shortened recovery time, improved lung function and hypoxemia, prolonged time to subsequent exacerbation, and reduced rates of treatment failure and hospital length of stay. It is as prevalent (if not more) in India as in western world.
Another ailment for primary care practice!

COPD is the fourth-leading cause of death in the United States and continues to increase in prevalence. Acute exacerbations of COPD (AECOPD) contribute significantly to this high mortality rate, which approaches 40% at one year in those patients requiring mechanical support.

An exacerbation of COPD has been defined as an acute change in a patient’s baseline dyspnea, cough, and/or sputum beyond day-to-day variability sufficient to warrant a change in therapy. Exacerbations commonly occur in COPD patients and often necessitate hospital admission.

The goals for inpatient management of AECOPD are to provide acute symptom relief and to minimize the potential for subsequent exacerbations. These are accomplished via a multifaceted approach, including the use of bronchodilators, antibiotics, supplemental oxygen, noninvasive positive pressure ventilation in certain circumstances, and systemic corticosteroids.

The administration of systemic steroids in AECOPD has been prevalent for several decades, with initial studies showing positive effects on lung function, specifically FEV1. Studies have demonstrated the benefit of steroids in prolonging the time to subsequent exacerbation, reducing the rate of treatment failure, and reducing length of stay (LOS). Corticosteroids have since become an essential component of the standard of care in AECOPD management.

Based on the evidence from de Jong and Lindenauer, it appears that there is no significant benefit to the use of IV over oral steroids. Additionally, there is evidence for oral administration being associated with beneficial effects on cost and hospital LOS.12 Oral steroids, therefore, are the preferred route of administration to treat a hospitalized patient with AECOPD, unless the patient is unable to tolerate oral medications. Current guidelines support the practice of giving oral steroids as first-line treatment for AECOPD

Though no guidelines define “high dose” and “low dose,” some studies have designated doses of >80 mg prednisone equivalents daily as high-dose and prednisone equivalents of ≤80 mg daily as low-dose. Recognizing these benefits, guidelines do favor initiating treatment with low-dose steroids in patients admitted with AECOPD.

The most recent publications from the American Thoracic Society/European Respiratory Society Task Force (ATS/ERS), the Global Initiative for Chronic Obstructive Lung Disease (GOLD), the National Clinical Guidelines Centre in the United Kingdom, and the Canadian Thoracic Society all recommend equivalent dosing of prednisone in patients admitted with AECOPD who are able to tolerate oral intake

More at: http://www.the-hospitalist.org/details/article/1072143/What_Corticosteroid_is_Most_Appropriate_for_treating_Acute_Exacerbations_of_CoPD.html