How should I assess the need for antibiotics in a patient experiencing an acute exacerbation of COPD?

Assess the presence of clinical features such as increased sputum volume, change in sputum colour and consistency, and worsening breathlessness, cough, or wheeze, which suggest an infective exacerbation of COPD ¹.

Consider antibiotic therapy if there is a suspicion of infection based on these features, especially if there is a change in sputum colour and increased volume or thickness beyond the person's normal variation ¹.

Reassess the patient if symptoms worsen rapidly or significantly, or if there are signs suggestive of a more serious illness such as pneumonia, cardiorespiratory failure, or sepsis, which may warrant antibiotics ¹.

Antibiotics should be considered on an individual basis, balancing uncertain benefit against severity of symptoms, need for hospital treatment, exacerbation and hospitalisation history, risk of complications, and previous sputum culture results ¹.