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Frequent COPD exacerbations — SCE Respiratory MCQ

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HardCOPDFrequent COPD exacerbationsSCE Respiratory

A 71-year-old ex-smoker with COPD has four exacerbations in 12 months despite LABA/LAMA/ICS, pulmonary rehabilitation and good inhaler technique. Sputum cultures repeatedly show no Pseudomonas, QTc is normal and hearing assessment is satisfactory. What is the most appropriate management?

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Correct answer: C — Consider long-term azithromycin after specialist review

Selected COPD patients with frequent exacerbations despite optimised inhaled therapy may benefit from long-term azithromycin after specialist assessment and safety checks. Indefinite broad-spectrum beta-lactam therapy is not recommended for prophylaxis. Lung volume reduction assessment is phenotype-specific and does not address the recurrent infective exacerbation pattern directly.

Reference: https://www.brit-thoracic.org.uk/quality-improvement/guidelines/