COPD stage of acute exacerbation | Microorganisms | Antibiotics |
---|---|---|
GOLD stages I and II | Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis | Penicillin, beta lactamase/enzyme inhibitor (amoxicillin/clavulanic acid), macrolides (clarithromycin, roxithromycin, azithromycin), first generation (cefazolin, cefradine) or second generation cephalosporins (cefuroxime, cefaclor), doxycycline, levofloxacin. |
GOLD stages III and IV; no risk factors for infection with Pseudomonas aeruginosa | Haemophilus influenzae, Streptococcus pneumoniae, Moraxella catarrhalis, Klebsiella pneumoniae, Escherichia coli, Enterobacteriacea | Beta-lactam/enzyme inhibitor (cefuroxime), second generation cephalosporins, fluoroquinolones (levofloxacin, moxifloxacin, gatifloxacin), third generation cephalosporins (ceftriaxone, cefotaxime). |
GOLD stages III and IV; risk factors for infection with Pseudomonas aeruginosa | All above microorganisms plus Pseudomonas aeruginosa | Third generation cephalosporins (ceftazidime), cefoperazone/sulbactam, piperacillin/tazobactam, imipenem, meropenem, can also be combined with aminoglycosides, fluoroquinolones (ciprofloxacin). |