COPD

First Line

Amoxicillin 500mg PO 8 hourly

or

Doxycyline 200mg PO STAT, then 100mg daily

or

Clarithromycin 500mg PO 12 hourly

 

 

Escalation

 Co-amoxiclav 625mg PO 8 hourly or 1.2g IV 8 hourly

First Line - Penicillin Allergy

Clarithromycin 500mg BD PO

or

Doxycycline  200mg PO STAT, then 100mg daily

Escalation - Penicillin Allergy

Mild-Moderate infection without sepsis: Co-trimoxazole 960mg PO 12 hourly

 

Severe infection/sepsis: Levofloxacin 500mg PO 12 hourly (consider safety issues)

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 if failure on first line antibiotic.

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

 

Treatment duration: 5 days.  Severe infection may require longer (e.g 7-10 days) guided by clinical response.