Antibiotic Guide for Non-pneumonic Chest Infections/Infective exacerbations of COPD (both community and hospital-acquired infections)

• Send sputum sample for culture

Is antibiotic therapy necessary?

2 or more of the following are required to gain benefit from antibiotic:

• increase in purulence of sputum
• increase in volume of sputum
• increase in breathlessness

1st line therapy:

• Doxycycline 100 mg PO BD (1st day) then OD (five day total course)

Review antibiotics with culture results

Patient not responding to antibiotics, has a resistant organism or failed recent course of doxycycline? Click here for alternative agents

If nil by mouth:

 IV Co-amoxiclav 1.2 g tds (convert to PO once taking oral medication) for 5 days (IV Cefuroxime 1.5g tds if non-severe penicillin allergy [e.g.mild rash only])

Notes

• Doxycycline has good activity against most respiratory pathogens including Strep. pneumoniae, Haemophilus, Moraxella, MRSA and atypical pathogens.

Page last edited: 25/07/2008

Caution; the antibiotic doses recommended on this website are intended for adult patients with normal renal and liver function unless otherwise stated. Dosing advice for patients with renal impairment is available here.

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