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Stepwise management. Stepwise management. Antibiotics are used to treat exacerbations that present with an acute detrioration (usually over several days) with worsening local symptoms (cough,increased sputum volume or change of viscoisity, increased sputum purulence with or without increasing wheeze, breathlessness, haemoptypsis) and/ or systemic upset. The flow diagram refers to three or more annual exacerbations. Adam T Hill et al. BMJ Open Resp Res 2018;5:e000348 ©2018 by British Thoracic Society
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