Question

Why are antibiotics considered with COPD exacerbations?

Answer 1

Why are antibiotics considered with COPD exacerbations?

In chronic obstructive pulmonary disease (COPD) exacerbations, antibiotics are considered with other medicines such as systemic corticosteroids, inhaled beta 2 agonists, inhaled anticholinergic etc.

Antibiotics are mainly considered because, bacteria are sometimes associated with exacerbation in some patients. But still this bacterial infection is implicated in only one third of the acute exacerbation COPD conditions. So we should understand the fact that antibiotics are not recommended for all patients with COPD exacerbation. Always give antibiotics to patients with symptoms of bacterial infections. Procalcitonin (PCT) can helps to identify whether antibiotics are essential for a patient and also to understand the duration of treatment needed with the same.

In the case of mild to moderate exacerbations, older broad-spectrum antibiotics such as doxycycline are preferred and in the case of severe exacerbations, augmented penicillins, third-generation cephalosporin’s etc. are preferred