COPD

First Line

Amoxicillin 500mg tds PO for 5 days

OR

Doxycyline 200mg stat, then 100mg od PO OR Clarithromycin 500mg bd PO for 5 days

 

 

Escalation

 Co-amoxiclav 625mg tds PO or 1.2g IV 8 hourly for 5 days

Penicillin Allergy

Clarithromycin 500mg bd PO for 5 days

OR

Doxycycline  200mg stat, then 100mg od PO for 5 days

Penicillin Allergy - Escalation

Levofloxacin 500mg daily  for 5 days or

Vancomycin IV as per protocol AND Ciprofloxacin 500mg bd PO/ 400mg IV 12hrly

Notes

TREATMENT WITH TWO ANTIBIOTICS IN THE ABSCENCE OF PNEUMONIC INVOLVEMENT IS UNNECESSARY

Treat if 2 of the following

  • purulent sputum
  • increased SOB
  • increased sputum volume

Pyrexia and tachycardia also indicative of infection

Send sputum for C+S  and viral throat swab and gargle

For patients who had adequate treatment with the recommended antimicrobials in the community and have not responded, then go directly to escalation