28th July 2023

Management

The first line treatment in the community is monotherapy with amoxicillin (erythromycin if penicillin allergic). If the patient is suspected of having an infective COPD exacerbation, then doxycycline is generally the preferred first line. COPD patients should also be supported with a 5-7 day oral steroids course and may require acute nebulisers.

For those requiring hospital admission, the first line is a broad-spectrum antibiotic, such co amoxiclav or ceftriaxone, with clarithromycin generally also given as cover for atypical infections, with doxycycline or levofloxacin as alternatives.

Exact guidance varies per area, so it is important to consult local guidelines. The treatment should be appropriately tailored if sensitivities indicate a more appropriate antibiotic.