Table 5.

Oral antimicrobials recommended in mild or moderate COPD exacerbations and community acquired pneumonia [34]

	Microorganisms	Empiric antibiotics*
		First choice	Alternative
COPD exacerbation (COPD-E)
Mild	H. influenzae S. pneumoniae M. catarrhalis	Amoxicillin-clavulanate 875-125mg/8h 5-7 days Cefditorena 400 mg/12h, 5 days	Levofloxacinc 500mg/24 h, 5-7 days Moxifloxacinc 400mg/24 h, 5-7 days
Moderate without risk factors for P. aeruginosa	H. influenzae S. pneumoniae M. catarrhalis+ Pen-R S. pneumoniae	Amoxicillin-clavulanate 875-125mg/8h 5-7 days Cefditorena 400 mg/12h, 5 days	Levofloxacinc 500mg/24h, 5-7 days Moxifloxacinc 400mg/d, 5-7 days
Moderate with risk factors for P. aeruginosa	P. aeruginosa	Ciprofloxacin 750 mg/12h, 5-7 days Levofloxacin 500 mg/12h, 5-7 days
Community acquired pneumonia (CAP)
Non severe CAP in <65 years, without significant chronic morbidity or without risk factors for infection with Gram-negatives or Legionella spp, irrespective of aetiological suspicion	S. pneumoniae H. influenzae M. pneumoniae	Amoxicillin 1g/8h, 5-7 days	Cefditorena 400mg/12h, 5 days Levofloxacinc 500mg/d, 5-7days Moxifloxacinc 400mg/d, 5-7 days
Non severe CAP in <65 years, with significant chronic morbidity or other risk factors for infection with Gram-negatives	S. pneumoniae H. influenzae K. pneumoniae/ other enterobacterial Legionella spp	Amoxicillin-clavulanic 875-125 mg/8h 5-7 days + macrolideb Cefditorenª 400mg/12h, 5 días +/- macrolideb	Levofloxacinc 500mg/d, 5-7días Moxifloxacinc 400mg/d, 5-7 días
CAP in COPD	S. pneumoniae H. influenzae M. pneumoniae	Amoxicilin-clavulanate 875-125 mg/8h 5-7 days +/- macrolideb Cefditorena 400mg/12h, 5 días

^*Dosing regimen correspond to current Spanish recommendations included in the guidelines and not that included in the summary of product characteristics:

^aIt should be prescribed if there is documented penicillin allergy or if the patient has been previously treated with amoxicillin or amoxicillin-clavulanate

^bAdd a macrolide (azithromycin 500 mg/24 h, 3 days or clarithromycin 500 mg/12, 7 days) if there are risk factor or suspicion of L. pneumophila infection

^cOnly recommended when a macrolide is not possible