Response: 

A worsening of the symptoms of COPD may be caused by an infection. There are 2 types of infection; those caused by bacteria, and those caused by viruses. A common example of a virus is the “cold virus” (rhinovirus), which in healthy people causes a sore throat and runny nose, but in COPD patients often causes more breathlessness and increased sputum production as well.

Antibiotics treat bacterial infections, not viral infections. It is often difficult to know whether a virus or bacteria has caused a worsening of symptoms. There can be some clues; if the sputum becomes green, this suggests a bacteria is the culprit, and if the episode starts with a runny nose then a virus could be to blame.

In an ideal world, your Doctor would like to take a sputum sample, and send it to the laboratory to find out if there are harmful bacteria in the sample before prescribing antibiotics. However, if you are very unwell, then the Doctor will have to make a decision on whether to prescribe antibiotics without waiting for the sputum result. The problem with this approach is that the infection may be due to a virus, and so the prescribing of antibiotics would not have aided the recovery. The unnecessary use of antibiotics does have some dangers, as all tablets can cause side effects, and the frequent use of antibiotics can cause some bacteria to become resistant to these drugs in future.

Keeping antibiotics at home is usually only done by patients who have frequent bacterial infections. This is done in agreement with their Doctor. The patient will usually know certain symptoms, such as an increase in volume and change in colour of sputum, that indicate a new bacterial infection. In such cases, taking antibiotics early can be beneficial

Summary:

Home antibiotics are reserved for COPD patients with frequent bacterial infections, and are usually only given to patients who have a good understanding of when their symptoms have changed due to a bacterial infection

Doctor D. Singh, September 2010