Acute Exacerbation of COPD

NHSL Antimicrobial Guidelines
NHS Lanarkshire

Many exacerbations are not caused by bacterial infections so will not respond to antibiotics. Consider an antibiotic, but only after taking into account severity of symptoms (particularly sputum colour changes and increases in volume or thickness), need for hospitalisation, previous exacerbations, hospitalisations and risk of complications, previous sputum culture and susceptibility results, and risk of resistance with repeated courses.

Drug details

Drug

Amoxicillin

Dosage

500mg

Duration

3 times a day 5 days

Drug

OR

Doxycycline

Dosage

200mg

then 100mg

Duration

on day 1

once daily for 4 further days

OR

Clarithromycin

500mg

twice daily for 5 days

Editorial Information

Last reviewed: 18/05/2022

Next review date: 18/05/2025

Author(s): Heather Boyle, NHS Lanarkshire Antimicrobial Management Committee, Dr Dundas, Dr Hylands, S McCormick.

Version: V1

Approved By: AMC; ADTC

Reviewer name(s): NHS Lanarkshire Antimicrobial Management Committee.

Document Id: June 2022