Antimicrobial prescribing: NHS Borders
Important: Therapy
Amoxicillin oral 500mg 8 hourly
Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Warning
What's new / Latest updates
Change in recommendations for severe and Pseudomonal infections.
Duration
Duration 5 days then review.
Important: Therapy
Penicillin allergy
Doxycycline oral 200mg on first day then 100mg daily
Notes:
Important: Therapy
Co-Amoxiclav IV 1.2g 8 hourly
Penicillin allergy – Discuss with Consultant Microbiologist
Notes:
Important: Therapy
1st line
Piperacillin-tazobactam IV 4.5g every 6 hours
Or, if penicillin allergy/outpatient treatment/IV to oral switch
Ciprofloxacin 750mg oral 12 hourly
Notes:
Important: Notes
Acute Exacerbation of Chronic Obstructive Pulmonary Disease
Patients with two or more of the three cardinal signs may benefit from treatment with antimicrobials
- Increased shortness of breath
- Increased sputum volume
- Purulent sputum
Antimicrobials should be tailored against previous isolates where possible.
Consider sending a throat swab in viral transport medium for respiratory viral studies.
Fluroquinolones
Refer to important safety information for all quinolones prior to prescribing.
See MHRA Drug Safety Update January 2024: Fluoroquinolones must only be used in situations when other antibiotics, that are commonly recommended for the infection, are inappropriate such as:
- there is resistance to other first-line antibiotics recommended for the infection
- other first-line antibiotics are contraindicated in an individual patient
- other first-line antibiotics have caused side effects in the patient requiring treatment to be stopped
- treatment with other first-line antibiotics has failed
Duration 5 days then review