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Draft NICE guidelines would restrict antibiotics in COPD

Why is NICE proposing to restrict the use of antibiotics in COPD patients?


Draft National Institute for Health and Care Excellence (NICE) recommendations would call on health professionals to consider the risk of resistance when treating or preventing a chronic obstructive pulmonary disease (COPD) flare up.


The draft recommendations have been published together with an update of the clinical guideline on diagnosing and managing COPD in over 16s.


The draft antimicrobial guidance recommends antibiotics should be offered to people who have a severe acute exacerbation, but also says resistance should be taken into account when considering antibiotic treatment for a less severe exacerbation.


The number and severity of symptoms should also be considered, under the new guidance.


About half of COPD exacerbations are believed to be caused by bacterial infections.


The draft clinical guideline on diagnosing and managing COPD states that antibiotic treatment to prevent exacerbations should be offered only to patients most likely to benefit from them.


The NICE COPD update committee chair said the benefits of prophylactic antibiotics should be balanced against the potential for resistance.


Further information

NICE: Chronic obstructive pulmonary disease (acute exacerbation): antimicrobial prescribing — draft for consultation July 2018

NICE: Chronic obstructive pulmonary disease in over 16s: diagnosis and management