12.3 Infective exacerbation of asthma/COPD
| Type of Infection | First Line (with Dosage and Duration) |
Alternative First Line (with dosage and Duration) |
Comments |
|---|---|---|---|
| Infective exacerbation* | Tab Amoxicillin- clavulanate 1g BD Or Tab Cefuroxime 500 mg BD Or Tab Cefpodoxime 200 mg BD | Inj Ceftriaxone 2g IV OD | Most commonly caused by viral respiratory infections. Antibiotics should be considered only if there is increased dyspnoea, increased sputum volume and increased sputum purulence [Anthonisen criteria] Duration of therapy: 3- 5 days |
For common etiological agents of Infective exacerbation of asthma/COPD, see Annexure B.12.3
Additional Information
*Symptoms of infective exacerbation are:
- Fever
- Sputum purulence
- Worsening bronchospasm
- Worsening oxygenation
References
1. Normansell R, Sayer B, Waterson S, Dennett EJ, Del Forno M, Dunleavy A. Antibiotics for exacerbations of asthma. Cochrane Database Syst Rev. 2018 Jun 25;6(6):CD002741. doi: 10.1002/14651858.CD002741.pub2. PMID: 29938789; PMCID: PMC6513273.
2. Siddiqi A, Sethi S. Optimizing antibiotic selection in treating COPD exacerbations. Int J Chron Obstruct Pulmon Dis. 2008;3(1):31-44. doi: 10.2147/copd.s1089. PMID: 18488427; PMCID: PMC2528209.
3. American Thoracic Society / European Respiratory Society Task Force. Standards for the Diagnosis and Management of Patients with COPD [Internet]. Version 1.2 http://www.thoracic.org/go/copd