Treatment of exacerbations of COPD

a. Treat for 10-14 days.

b. Trimethoprim/Sulfamethoxazole (Septra DS) 160/800 mg PO bid.

c. Amoxicillin/clavulanate (Augmentin) 500 mg tid or 875 mg PO bid [250,500,875 mg]; stable against beta lactamases; gastrointestinal side effects (diarrhea) are common.

d. Cefuroxime axetil (Ceftin), 250-500 mg PO bid; good activity against primary pathogens; stable against beta lactamase.

e. Cefixime (Suprax), 200 mg PO bid or 400 mg PO qd; stable against beta lactamase, lacks Staphylococcus aureus coverage.

f. Azithromycin (Zithromax), 500 mg on day 1, then 250 mg PO qd; reserved for treatment of infections due to Mycoplasma, Chlamydia, Legionella species.

g. Clarithromycin (Biaxin), 250-500 mg bid; moderate activity against H influenzae.

h. Levofloxacin (Levaquin) 500 mg PO qd. Broad spectrum coverage.

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We have all been there: turning to the refrigerator if feeling lonely or bored or indulging in seconds or thirds if strained. But if you suffer from bulimia, the from time to time urge to overeat is more like an obsession.

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