Amoxicillin for asthma flareup?

[Mandevilla]

I had an asthma attack last Wednesday which I treated at home. Rang the surgery Thursday to be told that the earliest available appointments were Friday, but that I'd need to call back on Friday to see if I was worse or if I could 'last' over the weekend. Called back Friday and was feeling a bit better, so was told to come in Monday.

Saw the person who specialises in respiratory conditions, and she seemed a bit thrown by the fact that I wasn't wheezing, although I did tell her that I don't wheeze. Told me that she couldn't prescribe oral steroids as "they are only for people who wheeze", but sent me home with amoxicillin instead.

I'm just a bit bemused as the packet says amoxicillin is for bacterial infections. My flareup was caused by a combination of external triggers and lack of sleep (sitting up for three nights caring for my mother who got chucked out of hospital with no care package). I've not had any kind of cough/cold etc for months. Is it common for amoxicillin to be prescribed for asthma that hasn't been triggered by a virus or was she just making assumptions?

[Lysistrata Administrator Community Ambassador]

Firstly, sorry to hear about your mother - hope she's doing better now. And hope you are too!

Honestly, it sounds like this person does NOT understand asthma. Oral steroids, as you probably know, aren't just for people who are wheezing and that alone would make me sceptical of their other advice. They should know better if they're the go-to for respiratory conditions!

If I had to guess, they're operating on an old-fashioned way of doing things which thinks that you should give antibiotics as a precaution to people with asthma just in case they might have an infection in there that triggered it.

I used to get this a lot in hospital 10-12 years ago where they'd always try to give me antibiotics whether or not I had any signs of infection of any kind. They often struggled with the idea that asthma attacks could be triggered by anything else! I quickly learned to push back and ask why they wanted to give antibiotics, and to say no if they said there wasn't evidence of infection.

I would check with the helpline (0300 2225800 Monday-Friday 9am-5pm, message on WhatsApp [phone] or email [e-mail]), but you probably need to push back and say that you don't understand the reasoning for what they've given you. THe helpline nurses should be able to help you with how best to do that.

[Poobah]

So sorry that you're struggling with so much on your plate. I agree with Lysistrata, it's always extremely useful to discuss things over with one of the Asthma UK helpline nurses. In the meantime, if your symptoms do flare up again, call the 111 service and ask for a walk in appointment over the weekend.

Do you have an asthma plan, where it guides you through increasing your asthma inhalers in order to bring an attack under control and if that doesn't work, to call 999? That's definitely something to discuss with your doctor. Not sure the respiratory clinician that you saw is well informed about asthma, from what you describe. I'd want to see my GP and get my records noted with expected symptoms of your silent asthma and if you usually have Prednisolone, to have that shown as usual treatment for asthma flares. That should all be written into your asthma plan in order to avoid any future misunderstanding.

I was reading a very useful piece today about how heart attack symptoms present in most women, so not as they present in men. But female symptoms can be overlooked, even by medical professionals, as they're not "classic". So asthma wheeze is "classic" but not for you or many other asthmatics who have silent asthma.

I know from other posts, silent asthmatics have created laminated information cards to present at A&E to focus the medical professionals on the asthmatic in front of them, rather than their idea of what they think asthma looks like.

Hope you feel better soon.

[Mandevilla in reply to Poobah]

I do have an asthma action plan, filled in by the asthma nurse at my surgery. One of the things it says is that I should see someone the day after having an attack which was treated at home - but in reality, it's impossible to do that, as when I call, I'm always told to wait 2-3 days to see if I improve!

This time, I had to wait from Thursday to Monday to see someone because it 'wasn't that serious'. But at the same time, I was told that it was 'too serious' to see the asthma nurse! (Which I would have preferred, because the asthma nurses at our practice listen to what we say and have excellent up-to-date knowledge!)

I'm recovering well, so I don't think I really need anything else at this stage. It's just annoying that when you do everything you can to keep healthy and 'protect the NHS', the medical staff themselves are not helping! I now have a wasted pack of antibiotics which has cost the NHS money, all due to an NHS employee's ignorance of asthma.

[Poobah in reply to Mandevilla]

On one occasion when I couldn't get a same day appointment with my GP re my asthma, I called 111 service and they decided I did indeed need a same day appointment and to call my GP surgery again. This time, when I called the surgery, they saw on my records that 111 had assessed my need for a same day appointment and BINGO, I was asked to pop in and saw a GP and got my emergency treatment. But receiving poor treatment (antibiotics) is unacceptable - just doesn't make any sense!

I must admit that my surgery have tightened things up in recent years, and all I have to say is I have an asthma flare and need to talk with a GP about additional treatment and there's no push back. I get a phone call from a GP and then they either prescribe per my plan or ask me to pop in (same day) to assess and prescribe.

Your surgery have unnecessarily given you the runaround and I would be disappointed with their lack of care and professionalism. Asthma UK has sound advice about giving your GP service feedback and seeking a resolution, asthmaandlung.org.uk/condit...

I hope you continue to recover.

[Mandevilla in reply to Poobah]

I've given up on 111 - every time I ring them, I get told either to cope until my GP can see me or to call an ambulance!!!

[Poobah in reply to Mandevilla]

This sounds like Russian roulette! I must admit, I haven't used 111 since covid and some services seem to have declined (weirdly, my GP surgery has improved its access). But I would be giving my surgery constructive feedback and next time you see your asthma nurse, you can request that your asthma plan is updated to reflect that you have silent asthma, want same day Prednisolone when seeking additional treatment for an asthma flare. All this next day/few days wait is not safe and the asthma nurse is well placed to frame how your future access is set up. Even ask them how you can better advocate for your asthma when you get pushback from the receptionist. They need to understand what's happening in their surgery.