Treatment Plan
Treatment Plan
Conservative:
- Chest physiotherapy for sputum clearance
Medications (for infective exacerbations):
First-line antibiotics (after sputum sample):
- Amoxicillin if no penicillin allergy
- If penicillin allergic: Clarithromycin/erythromycin
- Doxycycline (adults only)
- For those @ high risk of treatment failure: Co-amoxiclav/Levofloxacin – Specific antibodies for certain bacteria:
Strep. Pneumonia/H. Influenza [Beta lactamase -] = Amoxicillin
- Influenza [Beta lactamase +]/M. Catarrhalis = Co-amoxiclav
MSRA = Doxycycline
Klebsiella/P. Aeruginosa = Ciprofloxacin
Prophylaxis:
Azithromycin 500mg 3x/week for 6 months if ≥3 exacerbations Monitoring:
- LFTs at baseline, 1 month, then 6 months
- ECG (QT prolongation risk with macrolides)