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COPD infective exacerbation — GPhC CRA MCQ

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HardRespiratory TherapeuticsCOPD infective exacerbationGPhC CRA

A 68-year-old man with COPD asks for advice. He has increased breathlessness, sputum volume and purulent sputum for 3 days. His temperature is 37.9°C, respiratory rate 24/min and oxygen saturation is 91%, lower than his usual 94%. He has a rescue pack containing prednisolone and amoxicillin. What is the most appropriate action?

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Correct answer: A — Advise starting the rescue pack and arrange same-day clinical contact

Increased breathlessness with increased sputum volume and purulence supports COPD exacerbation with likely bacterial component. The lower oxygen saturation and tachypnoea justify same-day clinical contact, even if a rescue pack is available. Prednisolone and antibiotic use should follow the personalised exacerbation plan. Cough suppressants and waiting would risk deterioration.

Reference: NICE CKS COPD; NICE antimicrobial prescribing guidance