By rray, 29 January, 2024 Use of procalcitonin to guide abx tx not recommended if CRP low may consider withholding abx though more data needed
By rray, 29 January, 2024 Select abx based on local resistance patterns aminopenicillin w clavulanic acid macrolide tetracycline or quinolone in selected pts If frequent exac 2 per year severe airflow limits and or exac requiring ventilation cx from sputum lung material to evaluat
By rray, 29 January, 2024 Give abx x5 7 days Use controversial but indicated in pts who require ventilation invasive or not When indicated e g uarr sputum purulence volume dyspnea can darr recovery time hospitalization duration darr early relapse risk tx failure B duration 5 days
By rray, 29 January, 2024 Give systemic steroids prednisone 40 mg day x5 days A Oral is as effective as IV nebulized budesonide more expensive may be alternative to PO in some pts Steroids uarr FEV1 and oxygenation darr recovery time hospitalization duration use 5 days A Even shor
By rray, 29 January, 2024 Give short acting BDs SABA albuterol levalbuterol MDI NEB SAMA ipratropium MDI NEB C Use NEB hourly x2 3 doses then q2 4h Continuous NEB not recommended Air driven NEB preferred vs O2 driven to avoid potential uarr PaCO2 Use standard COVID 19 precautions