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Sixty patients with stable moderate COPD were randomised to receive one inhalation twice daily of either a combination of salmeterol 50\u2005\u03bcg plus fluticasone propionate 500\u2005\u03bcg or salmeterol 50\u2005\u03bcg for 12\u2005months. The primary outcome was the change of sputum bacterial loads over the course of treatment.<\/jats:p>\n                  <jats:p>Compared with salmeterol, 1-year treatment with salmeterol plus fluticasone was associated with a significant increase in sputum bacterial load (p=0.005), modification of sputum microbial composition and increased airway load of potentially pathogenic bacteria. The increased bacterial load was observed only in inhaled corticosteroid-treated patients with lower baseline sputum or blood eosinophil (\u22642%) levels but not in patients with higher baseline eosinophils.<\/jats:p>\n                  <jats:p>Long-term inhaled corticosteroid treatment affects bacterial load in stable COPD. 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