Patient’s Data​

Patient’s name: Steve Hutchinson

Age: 68-year-old male 

Past medical history

• Chronic Obstructive Pulmonary Disease (COPD)
• Osteoarthritis
• Chronic back pain
• Hypertension
• Raised Cholesterol 

Drug and Allergy History 

• Trimbow® NEXThaler 87/5/9 mcg – 2 inhalations twice daily
• Co-codamol – 1–2 tablets every 4–6 hours PRN; maximum 8 tablets/day
• Amlodipine 10 mg once daily
• Ramipril 5 mg once daily
• Atorvastatin 20 mg at night
• Sensitivity to Azithromycin (GI side effects) 

Recent notes/consultation 

Letter from Respiratory Specialty 

Re: Mr Steve Hutchinson | 68 years | Male 

Dear GP, 

I am writing to update you on the above-named, who was recently discharged from our care following a two-week hospital admission for an infective exacerbation of chronic obstructive pulmonary disease (COPD).

Mr Hutchinson has a history of frequent exacerbations despite maximal inhaled therapy. He had previously been trialled on Roflumilast 500 micrograms once daily, which was discontinued after two months due to lack of clinical benefit.

In view of persistent exacerbations, we commenced Azithromycin 500 mg three times per week for a trial period of six months. Unfortunately, this yielded no significant reduction in exacerbation frequency, and the patient experienced gastrointestinal side effects including abdominal discomfort and loose stools.

We held a detailed discussion with Mr Hutchinson regarding the options of either reducing the dose to 250 mg three times per week for another six months or stopping the medication altogether. After careful consideration, he opted to discontinue Azithromycin.

Mr Hutchinson remains under your care in the community. Should he require further specialist input or support from our team, please do not hesitate to get in touch.

Yours sincerely,

Dr James Rutherford, MBBS FRCP 

Consultant Respiratory Physician

Patient booked routine telephone consultation to discuss concerns