Exacerbation of chronic obstructive pulmonary disease: a role of antibiotics?

In order to discuss a role of antibiotics, a 73-year old patient was presented, having an exacerbation of Chronic Ob- structive Pulmonary Disease (COPD) and to whom amoxicillin/clavulanate antibiotic was prescribed. Literature search has indicated that antibiotics are recommended for COPD patients in two cases. Firstly, they are recommended in the patients having an acute exacerbation with increased dyspnoea, sputum volume, and sputum purulence. Common options usually include amoxicillin, amoxicillin/clavulanate, azithromycin, and doxycycline. Secondly, it is also recommended for preventive purposes in patients with severe COPD having frequent exacerbations. But, still remain uncertainty on the antibiotic used in outpatients, having mild or moderate COPD.