This guideline sets out an antimicrobial prescribing strategy for acute exacerbations of chronic obstructive pulmonary disease (COPD). It aims to optimise antibiotic use and reduce antibiotic resistance.

View 2-page visual summary
See a 2-page visual summary of the recommendations, including tables to support prescribing decisions.
See the NICE guideline on COPD in over 16s for other recommendations on preventing and managing an acute exacerbation of COPD, including self-management.


This guideline includes recommendations on:

Who is it for?

  • Health professionals
  • People with COPD, their families and carers

Guideline development process

How we develop NICE guidelines

NICE worked with Public Health England to develop this guidance.

Your responsibility

The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals and practitioners are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or the people using their service. It is not mandatory to apply the recommendations, and the guideline does not override the responsibility to make decisions appropriate to the circumstances of the individual, in consultation with them and their families and carers or guardian.

Local commissioners and providers of healthcare have a responsibility to enable the guideline to be applied when individual professionals and people using services wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with complying with those duties.

Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.

  • Public Health England
  • National Institute for Health and Care Excellence (NICE)