Group A: Patients not needing hospitalisation
>(mild COPD) | Patients with only one cardinal symptom should not receive antibiotics | | |
If indication then: | |
β-lactam (ampicillin/amoxicillin) Tetracycline Trimethoprim/sulfamethoxazole | β-lactam/β-lactamase inhibitor
>(Co-amoxiclav) Macrolides: azithromycin,
>clarithromycin, roxithromycin Cephalosporins (2nd or 3rd generation) Ketolides (telithromycin) |
| | | |
Group B: Patients admitted to hospital (moderate to very severe COPD without risk of
>P aeruginosa) | β-lactam/β-lactamase inhibitor
>(Co-amoxiclav) | Fluoroquinolones: gatifloxacin,
>gemifloxacin, levofloxacin, moxifloxacin | β-lactam/β-lactamase inhibitor
>(Co-amoxiclav, ampicillin/sulbactam) Cephalosporins (2nd or 3rd generation) Fluoroquinolones: gatifloxacin, levofloxacin, moxifloxacin |
| | | |
Group C: Patients admitted to hospital (moderate to very severe COPD with risk of
>P aeruginosa) | Fluoroquinolones: ciprofloxacin, levofloxacin (high dose) | | Fluoroquinolones: ciprofloxacin, levofloxacin (high dose) or β-lactam with P aeruginosa activity |