COPD acute exacerbation

.

Change antibiotic when sputum culture becomes available -only if bacteria are resistant and symptoms are not readily improving Chronic obstructive pulmonary disease -management of acute exacerbation antimicrobial prescribing. This a very useful guideline from NICE which has looked into the current evidence base of management of COPD exacerbation.NICE has set in definite terms what an exacerbation means. This will help clinicians recognize the event . In brief an exacerbation is Deterioration from baseline state It can manifest as○ worsening breathlessness○ cough○ increased sputum production○ change in sputum colour Various factors can cause an exacerbation for eg viral infections and smoking Not all exacerbations are caused by bacteria so will not respond to antibiotics

Severity-Mild- ↑ ed need for medication but can be managed at home Moderate -sustained worsening that requires Rx with steroids and or antibiotics Severe - rapid deterioration which requires hospital admission ( Oba Y et al 2017 ).Also based on symptoms ( ↑ed breathlessness ,↑ ed sputum , sputum purulence ) - can be classified as Type1 , Type 2 or Type 3.supporting symptoms include- cough , wheeze , fever without an obvious source , URTI in past 5 D's, ↑ ed RR or HR above...