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COPD (Chronic Obstructive Pulmonary Disease)

Correct management of COPD

03/27/2008

Question:

My Mum is 83 and has COPD. She was in hospital in November 2007 and has been on prednisone and antibiotics constantly since then. Again last week she had another lung infection which I have now realised is Pneumonia. I am concerned that her family Dr. is not giving her the correct antibiotics for her condition and only keeps giving her a treatment lasting a week.

Should she be seeing a respriatory specialist? Are there specific antibiotics that are used when there is a lung infection present and not the normal ones like what she has been given eg. Doxycycline. To me there is a lack of managing her condition correctly?

Answer:

Since your Mother has had repeated infections over such a long period of time, seeking the advice of a specialist is quite reasonable. Antibiotic therapy in treating exacerbations of COPD usually includes antibiotics that are effective against the most common causative organisms. Doxycycline is considered a first line drug. There are many drugs considered second line choices such as amoxicillin-clavulanate (Augmentin), azithromycin (zithromax), the fluoroquinolones (e.g. Avelox). Sputum cultures are not routinely performed unless patient is strongly suspected of having a bacterial infection and fails to respond to initial antibiotic therapy. In addition to antibiotic therapy, the need for bronchodilators, glucocorticoids, as well as oxygen therapy should be evaluated.

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Response by:

Gretchen   Whitby, APRN Gretchen Whitby, APRN
Nurse Practitioner of Chronic Obstructive Pulmonary Disease
College of Medicine
The Ohio State University

Phillip T Diaz, MD Phillip T Diaz, MD
Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University