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COPD exacerbation antibiotic choice — GPhC CRA MCQ

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EasyRespiratory TherapeuticsCOPD exacerbation antibiotic choiceGPhC CRA

A 63-year-old man with COPD (FEV1 45% predicted) presents with increased breathlessness and purulent sputum over the past three days. His temperature is 37.2°C. He currently takes tiotropium 18 micrograms once daily and salbutamol as required. He has no drug allergies. What is the most appropriate first-line antibiotic?

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Correct answer: B — Amoxicillin 500 mg three times daily for five days

This patient presents with an acute exacerbation of COPD with purulent sputum suggesting a bacterial cause. NICE recommends amoxicillin 500 mg three times daily for five days as first-line antibiotic treatment for COPD exacerbations. Doxycycline and clarithromycin are alternatives for penicillin-allergic patients. Co-amoxiclav and ciprofloxacin are not first-line for uncomplicated COPD exacerbations.

Reference: NICE NG115 COPD; BNF