Acute Infective Exacerbation of COPD
Antimicrobial prescribing: NHS Forth Valley
NICE Clinical Knowledge Summaries - Acute exacerbation of COPD
Many exacerbations (including some severe exacerbations) are non-infective or viral infections so will not respond to antibiotics
Treat exacerbations with antibiotics if purulent sputum AND one of increased shortness of breath or increased sputum volume
Risk factors for antibiotic resistant organisms and clinical failure include frailty, co-morbid disease, severe COPD (MRC>3), frequent exacerbations, antibiotics in last 3 months.
Drug details
Amoxicillin
500mg TDS
5 days
or:
Doxycycline
(avoid co-administration of Ca/Mg/Iron preps)
200mg stat then 100mg OD
5 days
If higher risk of clinical failure
(see comments above):
Co-trimoxazole
or
Guided by recent sputum culture sensitivity results
(Consider renal function and potassium with co-trimoxazole)
960mg BD
5 days