Clinical Research Directory

Inclusion Criteria: * COPD, according to GOLD 2018 definition * Indication for hospitalization because of acute severe exacerbation of COPD, as defined by GOLD 2018 and modified Anthonisen criteria * Presence of at least 2 major symptoms of the modified Anthonisen criteria (acute deterioration in sputum volume, sputum purulence and dyspnea) or the presence of 1 major symptom and 1 minor symptom (coughing, wheeze, nasal discharge, sore throat, fever) * Post-bronchodilator FEV1/FVC \< 0,70 and FEV1% \< 80%pred. within last 5 years * At least 40 years * Smokers or ex-smokers with \> 10 packyears * Written informed consent * Start of symptoms no more than 7 days before admission Exclusion Criteria: * Indication for ICU and or non-invasive ventilation \< 72h of admission * Pneumonia, radiologically confirmed * Infection at another site and/or sepsis according to the SIRS criteria (with tachycardia and tachypnea not being caused by the exacerbation) * COPD before age 40 * Asthma, without presence of COPD. * Patients with COPD , with or without a history of asthma (in childhood or as an adolescent) will NOT be excluded/are allowed to participate. * Patients with Asthma/COPD overlap syndrome (with current asthma AND COPD) will NOT be excluded/are allowed to participate. * Clinically relevant heart failure or myocardial ischemia * Chronic use of immunosuppressants, including prednisolone (a prednisone equivalent of 10mg or less is allowed/is NOT an exclusion criterion) * Known bronchiectasis as a primary diagnosis * Colonisation with Pseudomonas spp. or other micro-organisms in recent cultures (last 60 days) not susceptible to amoxicillin-clavulanic acid * Pregnancy * Recent exacerbation (last 28 days)