👉 COPD Exacerbation Treatment

Antibiotics of COPDAE

  • Amox,
  • TMP-SMX,
  • doxy,
  • azithro,
  • antipneumococcal FQ all reasonable (no single abx proven superior).
  • Consider local flora and avoid repeat courses of same abx. ≤5d course likely enough for mild-mod exacerbation (JAMA 2010;303:2035).
  • H. flu, M. catarrhalis, S. pneumo
  • ↑ PEF, ↓ Rx failure, ? ↓ short-term mort, ↓ subseq exacerb (Chest 2008;133:756 & 2013;143:82)
  • Consider if CRP >20 + ↑ sputum purulence or CRP >40 (NEJM 2019;381:111)