Chronic obstructive pulmonary disease antibiotics

One should consider infiuenza- and pneumococcal-vaccination in patients with increased risk for lower RTI including patients with chronic obstructive pulmonary disease like chronic bronchitis or emphysema and cystic fibrosis patients. It should be considered for the elderly population in general. There is no role for prophylactic antibiotic therapy in patients with frequent RTI. Attempts should be made to have those patients that smoke stop doing so. 

Saint S, Bent S, Vittinghoff E, Grady D. Antibiotics in chronic obstructive pulmonary disease exacerbations. A meta-analysis. JAMA 1995 273 957-60. 

Chronic obstructive pulmonary disease is a respiratory condition characterized by irreversible airway obstruction caused by chronic bronchitis or emphysema. The major symptoms of COPD include chronic cough, increased sputum production, and dyspnea. The vast majority of patients with COPD are those who are current or former heavy smokers. Other risk factors for the development of COPD include occupational exposure (dusts, chemicals) and rare genetic disorders (a -antitrypsin deficiency). The medical management of COPD includes pharmacotherapy (bronchodilators, corticosteroids, and antibiotics) in combination with interventions to reduce risk factors for disease progression (e.g., smoking cessation). Some patients require long-term administration of supplemental oxygen. 

Smith A, Ramsey B 1995 Aerosol administration of antibiotics. Respiration 62(suppl 1) 19-24 Soma L, Beech J, Gerber N 1987 Effects of cromolyn in horses with chronic obstructive pulmonary disease. Veterinary Research Communications 11 339-344 Sustronck B, Deprez P, Muylle E 1995 Evaluation of nebulization of sodium ceftiofur in the treatment of experimental Pasteurella haemolytica bronchopneumonia in calves. Research in Veterinary Science 59 267-271... 

Anthonisen NR, Manfreda J, Warren CPW, et al. Antibiotic therapy in exacerbations of chronic obstructive pulmonary disease. Ann Intern Med 1987 106 196-204. 

Azithromycin, an azalide macrolide antibiotic (500 mg p.o. as a single dose on day 1, followed by 250 mg daily on days 2 to 5 total accumulation dose is 1.5 g), is indicated in the treatment of acute bacterial exacerbations of chronic obstructive pulmonary disease caused by Haemophilus influenzae, Moraxella (Branhamella) catarrhalis, or Streptococcus pneumoniae mild community-acquired pneumonia caused by H. influenzae or S. pneumoniae uncomplicated skin and skin-structure infections caused by Staphylococcus aureus, Streptococcus pyogenes, or S. agalactiae second-line therapy of pharyngitis or tonsillitis caused by S. pyogenes and in nongonococcal urethritis or cervicitis caused by Chlamydia trachomatis. 

The HCP prescribed amoxicillin/clavulanate (Augmentin), an antibiotic, for a client diagnosed with chronic obstructive pulmonary disease (COPD) who has a cold. Which intervention should the nurse implement ... 

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