Infective Exacerbation of COPD | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Community Hospital Guidance
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Respiratory Tract Infection
Infective Exacerbation of COPD

Please update your RDS mobile app to version 4.7.1

We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.

You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.

To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:

On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.

On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.

Please get in touch with ann.wales3@nhs.scot with any questions.

First Line

Important: Therapy

Amoxicillin 500mg PO 8 hourly

or

Doxycyline 200mg PO STAT, then 100mg daily

or

Clarithromycin 500mg PO 12 hourly

Notes:

Second Line

Important: Therapy

Co-trimoxazole 960mg PO 12 hourly

(see BNF for dosing advice of co-trimoxazole in patients with renal impairment [<30 ml/min])

If oral route compromised: Ceftriaxone 2g IV 24 hourly (administered as per local SOP)

Notes:

Important: Notes

Treat with antibiotics if 2 of the following are present

purulent sputum
increased SOB
increased sputum volume

Pyrexia and tachycardia also indicative of infection

Send sputum for culture if possible and appropriate. Culture most useful where there has been poor clinical response to an empirical antibiotic previously or where antibiotic options are limited e.g. allergy, drug interaction.

Treatment duration: 5 days. Severe infection may require longer (e.g 7-10 days) guided by clinical response.