Antibiotics

Question 1

What are the probable pathogens of a simple AECOPD?

Answer 1

H. influenzae, M. catarrhalis, S. pneumoniae

Question 2

What is simple AECOPD?

Answer 2

Smoker, FEV1 >50%, <3 exacerbations/year

Question 3

What is complicated AECOPD?

Answer 3

Simple plus at least one of the following;
FEV1<50%, >4 exacerbations/year, ischemic heart disease, supplemental home oxygen, chronic oral steroids, antibiotic use in past 3 months

Question 4

What are the probable pathogens of complicated AECOPD?

Answer 4

Same as simple plus Klebsiella spp and other Gram-negative bacteria

Question 5

What is the first choice Abx for Simple AECOPD?

Answer 5

Amoxicillin, Cephalosporin (2nd/3rd generation), Doxycycline, extended spectrum macrolide, Trimethoprim-sulfamethoxazole

Question 6

What is the alternative ABX for Simple AECOPD?

Answer 6

Fluoroquinolone , Beta lactamase inhibitor

Question 7

What is the first choice ABX for complicated AECOPD?

Answer 7

Fluoroquinolone, Beta lactamase inhibitor

Question 8

What is Chronic Suppurative AECOPD?

Answer 8

Complicated AECOPD + constant purulent sputum, possible bronchiectasis, FEV1 <35%, chronic oral steroids; multiple risk factors

Question 9

What are the probable pathogens of Chronic Suppurative AECOPD?

Answer 9

Same as complicated + P. Aeruginosa and multi-resistant Enterobacteriaceae

Question 10

What ABX treats P.Aeruginosa?

Answer 10

Ciprofloxacin

Question 11

What is the recommended dose of prednisone for AECOPD?

Answer 11

25-50 mg for 7-14 days