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COPD exacerbation prevention — SCE Respiratory MCQ

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HardCOPDCOPD exacerbation preventionSCE Respiratory

A 63-year-old man with COPD has persistent productive cough and two exacerbations in 4 months. Sputum culture repeatedly grows Haemophilus influenzae. He is on LABA/LAMA and has not completed pulmonary rehabilitation. Blood eosinophils are 0.32 x 10^9/L. What is the most appropriate management?

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Correct answer: E — Optimise non-pharmacological care and consider ICS-containing triple therapy if exacerbations persist

In COPD with exacerbations, management should ensure pulmonary rehabilitation and inhaler optimisation; an ICS-containing regimen may be considered where exacerbation risk and eosinophils suggest likely benefit. Nebulised colistin is not standard for COPD with Haemophilus. Indefinite amoxicillin and immediate transplantation are not appropriate escalations.

Reference: NICE NG115 COPD