What is the Anthonisen classification for COPD exacerbations?

Type I (severe): all 3 symptoms (increased dyspnea + increased sputum volume + increased sputum purulence) - antibiotics reduce morbidity; Type II (moderate): 2 of 3 symptoms - antibiotics likely beneficial; Type III (mild): 1 symptom - antibiotics of no proven benefit.

What blood gas criteria indicate NIV in AECOPD?

NIV indicated: pH 45 mmHg and RR >23/min despite controlled O2; NIV reduces intubation by 65% and mortality by 50% in AECOPD with Type II respiratory failure; contraindications: GCS <8, vomiting, hemodynamic instability.

What antibiotic covers atypical organisms in AECOPD?

Mild-moderate AECOPD: amoxicillin-clavulanate or doxycycline; severe with Pseudomonas risk (frequent exacerbations, structural lung disease, recent antibiotics/steroids): anti-pseudomonal: ciprofloxacin or levofloxacin; respiratory FQs preferred if Pseudomonas not suspected.

What steroid dose and duration is used for AECOPD?

Prednisolone 40 mg/day for 5 days (REDUCE trial: 5 days equivalent to 14 days for time to next exacerbation); IV methylprednisolone 0.5 mg/kg/6h if unable to take oral; reduce hospitalisation duration and improve FEV1 recovery.

What is the optimal target oxygen saturation in AECOPD?

Target SpO2 88-92% in known or suspected COPD hypercapnia risk; high-flow oxygen (SpO2 >98%) increases mortality in AECOPD via Haldane effect (CO2 accumulation); use Venturi masks for precise FiO2 control in emergency setting.

COPD Exacerbation Risk and Antibiotic Eligibility Calculator

Calculates COPD exacerbation severity (Anthonisen criteria), antibiotic eligibility (3 cardinal symptoms: increased dyspnea, sputum, purulence), and guides amoxicillin-clavulanate vs respiratory FQ therapy and NIV threshold.

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Frequently Asked Questions

What is the Anthonisen classification for COPD exacerbations?

What blood gas criteria indicate NIV in AECOPD?

What antibiotic covers atypical organisms in AECOPD?

What steroid dose and duration is used for AECOPD?

What is the optimal target oxygen saturation in AECOPD?