Chest infection without steroids

[Particle32]

Hi, I am recently diagnosed with asthma - back in September with an awful 12 days in hospital after a cold became bronchitis. Was on oxygen etc. I am a man in early 40s.

I had another cold in early November which afterwards led to coughing up thick green stuff and bad wheezing. Took steroids and antibiotics which fixed it quickly.

Now had another bad cold and sinus issues over Christmas. The cold is slowly abating but it's gone to my chest again. My usual peak flow is 510 to 550. This morning it was 450 and I was wheezing. After I coughed up a load of stuff, it is back to 500 and wheeze has gone. However, I suspect the same will happen tomorrow.

Wondering if I should take my rescue steroids. I would rather not take them for the third time in four months. Does anyone ever take antibiotics but not the steroids? Last cold, it was worse and I hit 390 but maybe this time I will do so as well without steroids.

thanks

[Troilus]

Yes. With thick green phlegm I have taken antibiotics without prednisone and I usually see an improvement in about three days. I have also taken prednisone without the antibiotic when my breathing is affected but I don’t have a chest infection.

[Patk1]

Yes I sometimes take just antibiotics for infection if Airways don't seem inflamed x

[Chip_y2kuk]

Unfortunately if its a "viral infection" and there are a lot of them around at this time of year antibiotics and steroids won't do anything to help ... infact quite the opposite steroids weaken the immune system and so do antibiotics (meaning the virus gets to run riot a bit easier)

If its bacterial then you will need antibiotics, but not necessarily steroids

If your in danger of having a serious flare you may need steroids to "get you to the other side of it"

Your peak flow will drop with an viral respiratory illness (and will do regardless of asthma or no adthma)

I've been told any "funky coloured mucus" (anything other than clear,white or cream) will need antibiotics

Generally peak flows are:

80+% percent of your normal peak flow is normal (carry on as normal)

50-80% of your normal peak flow is yellow (not good, take action)

50% or less of your normal peak flow is red (medical emergency) ... at 50% you would know you needed help as you would be extremely breathless

[Lysistrata Administrator Community Ambassador in reply to Chip_y2kuk]

Funky-coloured phlegm is not automatically bacterial or a sign of needing antibiotics - it could also be a viral infection. It may be that you've had specific advice on using antibiotics but it's not always true that green/brown etc = bacterial+ antibiotics.

Particle32, it sounds as if you need to be seeing your GP if you're struggling with your chest, even if it comes and goes. Has anyone given you a personalised asthma action plan? If not it would be helpful - but it needs to work for you not be a template.

It's a bit of a balancing game with steroids given if you need them for asthma, as Chip_y2kuk says, then you need them and infections do tend to be a trigger for most people with asthma.

I also think if you're frequently needing steroid courses then you should be getting referred to a hospital team (current criteria is they encourage it if you've had more than 2 in a year). Unless you're already under a hospital team because you had a hospital admission? I can't remember if you said you already are but it's often recommended to be followed up after an admission.

I would also add that although peak flow can be helpful, good peak flow plus indications that asthma is not happy (eg blue inhaler helps but is wearing off quickly) still needs attention. It's not a straightforward relationship for everyone and ALUK says if you're having symptoms then you need to pay attention and see your GP, even if peak flow is ok (scroll down here to the yellow box): asthmaandlung.org.uk/sympto...

[Particle32]

thanks. I have now got antibiotics from a private gp through work. But I will book another appt with the nhs one to see what they think I should do. The hospital discharged me quickly from their care when I was in hospital as I recovered quickly. However whenever I get a cold I get worse. The rest of the time, I don't need the blue inhaler at all. I already have a referral to ENT as it seem linked to sinuses. I may ask to be sent back to lung people soon too.

It seems to be more linked to mucus. In a cold, I get congested, it goes to my chest, and then things go south. I don't seem to get breathless for other reasons.

The hospital experience was also fairly traumatic. So I get anxious when I get any chest symptoms at all, especially in a cold/infection. I find it hard to know when you're supposed to use rescue steroids.

anyway, will see how it goes for another day or two now I'm on the ABs.

[Patk1 in reply to Particle32]

It's worth getting drs permission to put a sputum specimen in,before starting antibiotics.x

[Fruitandveg]

I was also diagnosed with asthma 6 months ago during a 10 day hospital admission to the respiratory ward - a very alarming experience at the age of 76. I also have severe sinus issues, never experienced before, I have been prescribed Avamys 27.5 micrograms nasal spray which has really helped but not a quick fix it takes a few weeks to feel the benefits. Don’t hold your breath 😳 I have been feeling much better for the past 8 weeks, it’s taken months for my twitchy lungs to settle down a bit. Taken a while to get the inhalers right & for me to get control & recognise the triggers & symptoms. This forum has given me so much help, I haven’t posted much but I read every post, there is always something to gain from the advice & others experiences. I am hoping for a healthy 2024 & wish the same for everyone on here.

[DaveW27]

Yes I have taken atnibiotics without steroids for a chest infection nand it worked fine for me. Best to consult your GP though.

[Particle32]

I've gone to gp. He's given me extra steroid inhaler to take. I still have wheezing but he said that it's worth waiting a bit to see whether things improve. My peak flow is bad in the morning but gets better. So, I will wait.

I could really do without these virus/asthma cycles, especially as I'm going back to work now.

[Particle32]

Hi all, my peak flow has been going down again, mainly due to mucus in lungs. I woke up today and it was 350. I later took two blue puffs, which initially made no difference. Then, I coughed up a load of thick green mucus and it went back to 460.

I've still not taken pred but feel it's heading in that direction... Don't know if I should take straight away now. Each day seems to be getting worse.

Have any of you managed to escape this cycle of cold leading to chest infection, leading to being too clogged up, not being able to cough stuff up, and then needing steroids again?

Thanks.