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The most appropriate treatment for an older patient with chronic obstructive pulmonary disease (COPD) who develops a fever and changes in sputum is an antibiotic. In such cases, the patient may be experiencing an exacerbation of their COPD due to a respiratory infection, which is indicated by the presence of fever and altered sputum characteristics, such as increased purulence or volume.

Bacterial infections are common triggers for exacerbations in patients with COPD, and the development of fever often suggests an infectious process. Administering an antibiotic can help address any potential bacterial infection, reduce the inflammation in the airways, and improve the overall clinical condition of the patient. In older adults, timely treatment of infections is crucial due to their increased vulnerability to complications.

Corticosteroids, inhaled bronchodilators, and nebulizer treatments can be helpful in managing symptoms and airflow limitation in COPD but are not specifically aimed at treating the underlying infection. While using steroids can reduce inflammation and bronchodilators can help open the airways, these treatments do not combat the bacterial infection indicated by the fever and sputum changes. Therefore, the antibiotic is the most targeted and appropriate choice in this scenario to manage the suspected infection.