Q. A 66-year-old man has presented to the medical outpatient department with worsening dyspnea and cough for the past week. He reports a persistent cough with yellowish-green sputum production. He has had a history of smoking for 40 years and has had several episodes of respiratory infections in the past year. On physical exam, his Blood pressure is 140/90 mmHg, heart rate is 90 beats per minute, respiratory rate is 24 breaths per minute, and oxygen saturation is 88% on room air. Bilateral wheezes and decreased breath sounds were noted on chest auscultation. His cardiovascular exam is unremarkable. Laboratory findings include white blood cell count elevated at 12,000/mm3 with a neutrophil predominance, and arterial blood gas analysis reveals pH 7.35, PaO2 50 mmHg, PaCO2 50 mmHg. Spirometry reports FEV1 reduced at 35% of predicted. What is the most appropriate management for this patient?