Question

A 72-year-old man with moderate COPD presents with increased dyspnoea, sputum volume and purulent sputum over 3 days. He is afebrile, saturating 94 percent on room air, with mild wheeze on examination. He normally uses a long-acting muscarinic antagonist and a long-acting beta agonist inhaler, and has had one exacerbation in the last year. What is the most appropriate management for this exacerbation?

Accepted Answer

Start a short course of oral prednisone and antibiotics targeting common respiratory pathogens.

Answer

Increase use of short-acting bronchodilators only; no steroids or antibiotics.

Answer

Admit for intravenous steroids and broad-spectrum intravenous antibiotics.

Answer

Add theophylline and continue regular inhalers only.

Answer

Start long-term macrolide prophylaxis instead of acute antibiotics.

Practice question