Table 2 Recommendations for assessing outpatients for treatment with systemic corticosteroids and antibiotics
Criteria | No. of guidelines | Countries/organisations applied (ISO codes) a |
|---|---|---|
Systemic corticosteroids | ||
All patients with AECOPD | 9 | ZA, AU/NZ, IN, NO, SW, ES b , ICSI, GOLD, UpToDate |
Baseline FEV1% predicted <50% | 1 | AT |
Stadium III | 1 | AT |
Moderate to severe COPD | 2 | CA, DK |
Significant increase in dyspnoea/wheezing | 3 | SE, IPCRG, NICE |
Impaired general condition | 1 | NL |
Treatment failure of first-line treatment (bronchodilators) | 1 | NL |
Respiratory rate>25/min, heart rate>110/min, SpO2<90%, PaO2<8 kPa | 1 | SE |
Antibiotics | ||
All patients with AECOPD | 2 | IN, KSA |
Severe underlying COPD | 4 | DE, NO, ERS, NL |
Increase in dyspnoea, cough, sputum volume and purulence | 3 | CA, IPCRG, NL |
Increase in dyspnoea, sputum volume and purulence (2 or 3 of 3 symptoms) | 6 | ZA, GOLD, ERS, SUI, ICSI, UpToDate |
Increase in sputum volume and colour | 2 | AT, AU/NZ |
Change in sputum colour/purulent sputum | 6 | NO, SE, DK, NICE, DE, ES |
Insufficient improvement after 4 days | 1 | NL |
Clinical signs of pneumonia | 2 | DK, NICE |
Fever | 5 | AU/NZ, AT, NO, DK, NL |
Impaired general condition | 2 | DK, NL |
Use of accessory muscles | 1 | NL |
Respiratory rate>30/min, heart rate>120/min | 1 | NL |
Leukocytosis | 1 | AU/NZ |
CRP>50 mg/l | 1 | NO |
Procalcitonin>0.1 ng/ml | 1 | DE |
Chest radiography | 1 | NICE |
