Acute exacerbation of COPD

NICE COPD

GOLD

Treat exacerbations promptly with antibiotics if purulent sputum and increased shortness of breath and/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.

If treatment failure, send sputum samples for sensitivity testing.

Drug details

Amoxicillin

500mg TDS

5 days

or Doxycycline

200mg stat then 100mg OD

5 days

or Clarithromycin

500mg BD

5 days

If higher risk of clinical failure (see Comment above): Co-trimoxazole

960mg BD

5 days