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Acute exacerbation COPD


CFPT Adult Antimicrobial Guide

RCHT Adult Antimicrobial Guide

NICE COPD quick reference guide


Initial Community Management


Increase frequency of bronchodilator use and consider giving via nebulizer.

(The Acute Care at Home Team can provide short-term nebulizers).


Give oral antibiotics if any 2 out of:

  •       Increased sputum volume

  •       Increased sputum purulence

  •       Increased breathlessness

Consider treatment with antibiotics as per antimicrobial guidelines.


Prednisolone daily for 7-14 days (there is no advantage in prolonging therapy).

Sputum culture is not normally recommended.

Use pulse oximetry if the exacerbation is severe.

Consider Acute Care at Home management

Contact on 01872 221415 or via Bodmin switch 01208 251300


The IToCHs can arrange emergency packages of care, monitoring (via Virtual Ward) or equipment to enable management at home.


Monitor Recovery


Arrange appropriate review.

Advise smoking cessation.

Discuss referral to a pulmonary rehabilitation programme.

Establish optimal ongoing therapy.

Arrange multidisciplinary assessment if necessary.

Give clear instructions about correct use of medication including oxygen.



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