COPD — UKMLA MCQ

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HardRespiratory medicineCOPDUKMLA MRCP Part 1

An adult with COPD has increased dyspnoea, sputum volume and purulence. Oral treatment is suitable. He has immediate penicillin allergy and completed clarithromycin six weeks ago; local susceptibility does not suggest resistance to tetracyclines. Which antibiotic is the best listed choice?

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Correct answer: B — Doxycycline

The best answer is “Doxycycline”. Doxycycline is a first-choice oral option in NICE guidance and avoids both the immediate penicillin allergy and recent macrolide exposure. Amoxicillin and co-amoxiclav are unsuitable with immediate allergy. Repeating clarithromycin may select resistance after recent use, while levofloxacin is reserved for situations in which other recommended antibiotics are unsuitable and requires attention to serious adverse-effect restrictions.

Reference: NICE NG114, COPD acute exacerbation antimicrobial prescribing: https://www.nice.org.uk/guidance/ng114/chapter/Recommendations