Acute Exacerbation of COPD

Doses are oral and for adults unless otherwise stated. Visit the Health Products Regulatory Authority (HPRA) website for detailed drug information (summary of product characteristics and patient information leaflets). Dosing details, contraindications and drug interactions can also be found in the Irish Medicines Formulary (IMF) or other reference sources such as British National Formulary (BNF) / BNF for children (BNFC). See guidance on dosing in children for quick reference dosage/weight guide. Refer to drug interactions table for detailed drug interactions for all antimicrobials. Note extensive drug interactions for clarithromycin, fluoroquinolones, azole antifungals and rifampicin. Many antibiotics increase the risk of bleeding with anticoagulants.

Note additional warnings for clarithromycin and fluoroquinolones

Comments from Expert Advisory Committee

  • 30% viral, 30-50% bacterial, rest undetermined.
  • Use antibiotics if increased dyspnoea and increased purulence of sputum volume. B+
  • In penicillin allergy use clarithromycin if doxycycline contraindicated.
  • Azithromycin use, particularly if prolonged, is associated with prolonged QT syndrome.  It should not be used for the prevention of exacerbations of COPD except under the direction of a respiratory physician.


COPD treatment table 2019

See guidance on dosing in children for quick reference dosage/weight guide

Patient Information

The HSE Health A-Z website provides patient information on many hundreds of conditions and treatments.

We recommend patients use the website developed by HSE/ICGP/IPU partnership for tips on how to get better from common infections without using antibiotics, what you can do for yourself or a loved one and when to seek help.

Reviewed November 2017

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