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Preventing acute exacerbations helps to reduce long-term complications.Long-term oxygen therapy, regular monitoring of pulmonary function and referral for pulmonary rehabilitation are often indicated.Antibiotic therapy is directed at the most common pathogens, including .Mild to moderate exacerbations of COPD are usually treated with older broad-spectrum antibiotics such as doxycycline, trimethoprim-sulfamethoxazole and amoxicillin-clavulanate potassium.All patients with COPD who smoke should be counseled about smoking cessation.Influenza and pneumococcal vaccinations are recommended for all patients with COPD.Treatment with augmented penicillins, fluoroquinolones, third-generation cephalosporins or aminoglycosides may be considered in patients with more severe exacerbations.

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