COPD and antibiotics

Published in Medicinewise Living

Date published: About this date

Most respiratory tract infections, such as colds and flu, are caused by viruses. If you are generally healthy and well, your body can fight the virus and get better without any treatment. Taking antibiotics won’t help, because antibiotics don’t kill viruses.

However, if you have long-term lung problems, such as chronic obstructive pulmonary disease (COPD), you may be at a higher risk of complications from a cold, flu or other respiratory tract infection (e.g. a second infection caused by bacteria). In these circumstances, antibiotics may be an appropriate treatment for you.

COPD and bacterial infection

As many as half the people with COPD or chronic bronchitis (i.e. bronchitis that has lasted for 2 or more months) will have bacteria living permanently in their airway passages, without causing an infection. This is called ‘colonisation’.

If you have COPD and you get a viral respiratory tract infection, there is a risk that these colonising bacteria will start to multiply, causing an infection (e.g. pneumonia). The chance of this happening is higher if you have COPD as well as another medical condition (e.g. diabetes), because you are more at risk of complicated infections.

How are these bacterial infections treated?

Antibiotics

Research has shown that if people with COPD are treated with antibiotics at the first sign of a respiratory infection (e.g. a cold or flu), they are much less likely to be admitted to hospital.

So, if you do have COPD and a respiratory tract infection, your doctor will look for these early signs and may prescribe an antibiotic (usually amoxicillin or doxycycline) for you.

Other medicines

There are other medicines you can take to help manage the symptoms of a respiratory tract infection. These include paracetamol or ibuprofen for relieving pain and fever, and decongestants and saline nasal sprays or drops for relieving a blocked nose. Some of these over-the-counter medicines may not be suitable for you, so always check with your doctor or pharmacist before using them.

Your doctor may also prescribe corticosteroids (e.g. prednisone) and/or bronchodilators to help you breathe more freely (e.g. salbutamol, terbutaline, or ipratropium bromide), as well as your regular medicines while you are ill.

What about antibiotic resistance?

Antibiotics are one of our most important weapons against bacterial infections. However, overuse and misuse of antibiotics over time have allowed bacteria to change and ‘resist’ the effect of an antibiotic. When this happens, that antibiotic will no longer kill the resistant bacteria or stop them from multiplying. This is called antibiotic resistance.

Taking antibiotics when they aren’t needed, or not using them exactly as your doctor prescribed, can contribute to antibiotic resistance and the spread of ‘superbugs’ in our community.

If you have COPD, you are more likely to need — and to be prescribed — antibiotics when you have a respiratory tract infection, so you shouldn’t feel hesitant about taking antibiotics if they are prescribed for you. In fact, the Australian Therapeutic Guidelines — a guide for doctors about the best way to treat different illnesses — recommends antibiotics to treat respiratory tract infections in people with COPD.

You can take antibiotics and prevent antibiotic resistance

Even if you are taking antibiotics, you can still help prevent antibiotic resistance. By taking the antibiotics at the right dose and time, for as long as directed by your doctor and by not sharing them with anyone else, you are helping to prevent antibiotic resistance as well as looking after your own health.

Prevention is better than cure

It’s very important for people with long-term lung problems to have the influenza (flu) and pneumococcal vaccinations. If you have COPD or another chronic lung disease you may be eligible to receive these vaccinations for free (although your doctor may still charge their usual consultation fee).

Flu vaccines are given annually. Check with your doctor about whether you need (and are eligible for) the pneumococcal vaccine.

Simple ways to prevent infection

Research has shown there are some very simple but very effective ways to avoid catching, or spreading, a respiratory tract infection – even serious ones.

  • Stay at home if you are unwell.
  • Use a tissue when coughing or sneezing then throw it away.
  • Wash your hands with soap and running water, particularly after coughing or blowing your nose, and before preparing or eating food.
  • Avoid touching your eyes, nose and mouth.
  • Don’t share cups, glasses and cutlery.
  • Keep household surfaces clean.

Find out more