Table 10

Level I: outpatient treatment

Patient education
 Check inhalation technique
 Consider use of spacer devices
 Short-acting β2‐agonist# and/or ipratropium MDI with spacer or hand-held nebuliser as needed
 Consider adding long-acting bronchodilator if patient is not using one
Corticosteroids (the actual dose may vary)
 Prednisone 30–40 mg orally·day−1 for 10–14 days
 Consider using an inhaled corticosteroid
 May be initiated in patients with altered sputum characteristics+
 Choice should be based on local bacterial resistance patterns
 Amoxicillin/ampicillin, cephalosporins
 If the patient has failed prior antibiotic therapy consider:
  Respiratory fluoroquinolonesƒ
  • MDI: metered-dose inhaler

  • #: salbutamol (albuterol), terbutaline

  • +: purulence and/or volume

  • : depending on local prevalence of bacterial β‐lactamases

  • §: azithromycin, clarithromycin, dirithromycin, roxithromycin

  • ƒ: gatifloxacin, levofloxacin, moxifloxacin