Table 2.

  Global Initiative for Chronic Obstructive Lung Disease Guidelines for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) Severity and Need for Antibiotics

AECOPD Category	Hospitalization	Exacerbation	Clinical	Organisms	Antibiotics
A	No	Mild	• No risk factors for poor outcome  No comorbidity  No frequent exacerbations  No severe Stage IV COPD  No recent antibiotic use • Only one cardinal symptom of chronic bronchitis	H. influenzae S. pneumoniae M. catarrhalis C. pneumoniae Viruses	No
B	Yes	Moderate	• Risk factors(s) for poor outcome • No risk factor for P. aeruginosa infection	Group A plus penicillin‐resistant S. pneumoniae Enterobacteriaceae Klebsiella pneumoniae Escherichia coli Proteus Enterobacter	Yes
C	Yes	Severe	• Risk factor(s) for poor outcome and P. aeruginosa infection  Recent hospitalization   Frequent administration of antibiotics (≥4 courses in previous year)   Stage IV COPD   Isolation of P. aeruginosa during previous exacerbation or during a stable period	Group B plus P. aeruginosa	Yes

Adapted from GOLD Guidelines. ⁴³