Prescription: COPD: Doxycycline

Casebank Prescription
1

Where you are
You are an FY2 in A&E.

Who the patient is
Mr. John Smith, aged 50, has admitted to the ward for the acute exacerbation of COPD.

Other Information you have about the patient
None

What you must do
Prescribe:
Antibiotics of Choice
Seretide 250 EVO haler One puff BD
Salbutamol 100 micrograms 1 to 2 puffs PRN

Special Note
Patient is allergic to penicillin & Clarithromycin. Patient had rash.

Shortcut:

  1. Once-only: Loading dose: DOXYCYCLINE 200mg PO
  2. Antibiotic: Maintenance dose: DOXYCYCLINE 100mg PO OD 4 days
    Additional information: Review after 4 days.
  3. Regular: SERETIDE 250 EVOHALER, Dose 1 puff INH BD
  4. PRN: SALBUTAMOL 100 MICROGRAMS, Indication COPD, Dose 1-2 puffs INH 6 hourly, Max 8 puffs

Explanation:

  • 1st line penicillin: Amoxicillin
  • 2nd line Clarithromycin (Hold statin)
  • 3rd line Doxycycline
    – Doxycycline 200 mg PO in once only section
    – Doxycycline 100 mg PO OD for next 4 days. Start date will be the next day & cross out the last column which will be empty.
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