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AECOPD First-Line Antibiotic — SCE Infectious Diseases MCQ

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EasyRespiratory InfectionAECOPD First-Line AntibioticSCE Infectious Diseases

A 55-year-old man with COPD develops an acute exacerbation. He has had 2 exacerbations in the past year, both treated with Amoxicillin. Sputum is purulent. He has no penicillin allergy. Per NICE COPD guidelines, what is the first-line antibiotic for an acute exacerbation?

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Correct answer: C — Amoxicillin 500 mg TDS for 5 days — NICE first-line for AECOPD with purulent sputum

NICE NG115 (2019) recommends Amoxicillin 500 mg TDS as first-line for AECOPD with purulent sputum (in the absence of known resistant organisms). Duration: 5 days. Alternatives: Doxycycline or Clarithromycin. Co-amoxiclav is reserved for failure or known beta-lactamase-producing organisms. Fluoroquinolones (Ciprofloxacin) should be reserved for Pseudomonas or specific indications — NOT routine AECOPD.

Reference: NICE NG115 2019 – COPD; BNF 2024