2.  Chronic obstructive pulmonary disease exacerbation.  The patient is doing well, taking PO.  We will continue him on his oral Omnicef and azithromycin and continuing breathing treatments.  We will add guaifenesin and N-acetyl-cysteine in a hope to mobilize some of his secretions.  This does appear to be improving.  His white count is normalized and I am hopeful we can discharge him on oral antibiotics within the next 24 to 48 hours if there are no further complications.