Acute Exacerbation of COPD | Right Decisions

Right Decisions
Antimicrobial prescribing: NHS Forth Valley
Primary Care Guidance
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LOWER RESPIRATORY TRACT INFECTIONS
Acute 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.

Acute exacerbation of COPD

Many exacerbations (including some severe exacerbations) are not caused by bacterial infections so will not respond to antibiotics

NICE NG 114

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

First choice

Amoxicillin

500mg TDS

5 days

Or

Doxycycline

200mg stat then 100mg OD

5 days

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

Guided by recent microbiological cultures or Co-trimoxazole

960mg BD

5 days