Infective Exacerbation of COPD/Exacerbation of chronic bronchitis

Micro-organism

Only 30-50% infections are bacterial

Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis

Duration

Mild to Moderate: 5 days

Severe: 7 days

Notes
  • Collect sputum

Give antibiotics if patient has a history of COPD and both the following are present;

  • Development of purulent sputum (dark green, not yellow)
  • WBC is >10 x 109/L and/or CRP is elevated

Use first line antibiotic unless recent hospitalisation or recent antibiotic.

Mild- Moderate - 1st Line

Oral Amoxicillin 1g 8 hourly

Mild - Moderate - Penicillin Allergy

 Oral Doxycycline 200mg on day 1 then 100mg daily

Severe - 1st Line

IV Co-trimoxazole 960mg 12 hourly

then switch to oral Co-trimoxazole 960mg 12 hourly

OR

Oral Doxycycline 200mg oral stat then 100mg 12 hourly

Severe - 2nd Line

Oral/IV Clarithromycin 500mg 12 hourly