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Table 2 Application of antibiotics at each stage of AECOPD

From: Xuan Bai Cheng Qi formula as an adjuvant treatment of acute exacerbation of chronic obstructive pulmonary disease of the syndrome type phlegm-heat obstructing the lungs: a multicenter, randomized, double-blind, placebo-controlled clinical trial

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).
  1. Abbreviations: AECOPD acute exacerbation of chronic obstructive pulmonary disease, COPD chronic obstructive pulmonary disease, GOLD Global Initiative for Chronic Obstructive Lung Disease.