Safety and Tolerability of Nebulized Amoxicillin-Clavulanic Acid in Acute Exacerbations of COPD.

1. A clinical diagnosis of COPD, as defined by GOLD criteria;

2. Hospitalized for an acute exacerbation of COPD;

3. Admitted to ward A4 or C4;

4. Able to produce sputum;

5. Age 40 years or over;

6. Current or former smoker.

1. Current pneumonia, defined as an acute respiratory tract illness associated with radiographic shadowing on a X-ray or CT-scan of the chest which was neither pre-existing nor of any other cause;

2. Allergy for penicillin, amoxicillin or clavulanic acid. (patients must have been treated with amoxicillin before without a report of allergic reactions);

3. History of severe AECOPD requiring mechanical ventilation;

4. Recently diagnosed or unresolved lung malignancy;

5. Impaired renal function (Creatinine Clearance < 20 ml/min);

6. Congestive Heart Failure (NYHA III-IV).



During the trial the patient cannot be treated with systemic amoxicillin clavulanic acid.