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COPD exacerbation antibiotic stewardship — GPhC CRA MCQ

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HardRespiratory TherapeuticsCOPD exacerbation antibiotic stewardshipGPhC CRA

A 68-year-old man with COPD asks for antibiotics from a pharmacy service. He has increased breathlessness and sputum volume, but sputum remains clear. His oxygen saturation is 95%, temperature 36.9C and he has no chest pain. What is the most appropriate action?

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Correct answer: D — assess severity and advise self-care or referral rather than automatic antibiotic supply

Antibiotics for COPD exacerbations are most useful when bacterial features are present, particularly purulent sputum with increased volume or breathlessness. This patient has increased symptoms but clear sputum and stable observations, so automatic antibiotic supply is not justified. The pharmacist should assess severity, inhaler use and red flags, and refer if clinically indicated. Fluoroquinolones are not routine first-line choices for uncomplicated COPD symptoms.

Reference: BNF; NICE CKS: COPD