Table 11

Level II: treatment for hospitalised patient

 Short-acting β2‐agonist and/or
 Ipratropium MDI with spacer or hand-held nebuliser as needed
Supplemental oxygen (if saturation <90%)
 If patient tolerates, prednisone 30–40 mg orally·day−1 for 10–14 days
 If patient can not tolerate oral intake, equivalent dose i.v. for up to 14 days
 Consider using inhaled corticosteroids by MDI or hand-held nebuliser
Antibiotics (based on local bacteria resistance patterns)
 May be initiated in patients that have a change in their sputum characteristics#
 Choice should be based on local bacteria resistance patterns
 Respiratory fluoroquinolones (gatifloxacin, levofloxacin, moxifloxacin)
 If Pseudomonas spp. and/or other Enterobactereaces spp. are suspected, consider combination therapy
  • MDI: metered-dose inhaler

  • #: purulence and/or volume