Hi, I am back asking for more advice after my husband was readmitted to hospital with another infection, just three weeks after being discharged following 32 days incarceration which, at one point was life threatening. This earlier infection was eventually cleared "completely" (I know pseudomonas lurks!) with meropenem.
Initially his CRP levels were 155 (not bad compared to the 302 he had previously) so we hoped this one would be short lived. 10 days on Tazocin they were down to 60ish so, in their wisdom the docs decided to stop the ABs and see what happened (reason stated was they needed to have some leeway in case the infection got worse??) Needless to say, blood test two days later showed they had increased to 95 so back on Tazocin for the remaining four days of 14 day cycle. He had another blood test today - two days after restart - and the levels have increased to 103. Surely if the AB is working the CRP would reduce? The doc is still continuing to administer the same antibiotic and says they will review on Monday.
The other issue is his SATS keep dropping without oxygen - he is maintaining 90 with 2-3 litres per minute - but has never needed supplementary oxygen above 1 litre even with an infection. He does not have oxygen at home.
He was also diagnosed with bronciectasis during the previous admission (which had shown on CT scan in October but we weren't told about it).
I know contributors on here are not medics but some are very experienced in these conditions. Dare I ask the question - is this treatment appropriate? Thank you.
Sorry I can't help you but just wanted to wish you and your husband all the best. Someone should be along soon who has better experience of what you're going through.
I had repeated sinus and chest infections for 18 months. They found pseudomonas when I was having a sinus wash and repeated doses of cipro didn’t clear it. In fact the infections became resistant to cipro. I had two weeks iv tazocin and ceftazine which I did at home to kill it and I now nebulise colomycin I’ve been doing this since last July and have been told I will be doing so until at least next January. I’m in a slightly different situation from your husband as I have a suppressed immune system so am unable to fight infections myself but it’s still miserable constantly having infections whatever is wrong with you. Does your husbands doctor specialise in Bronchiectasis? I think that can make a big difference. I hope he can get some relief from this soon. X
At the risk of sounding bitter and twisted, I don't think the respiratory docs at our hospital know what they are doing. The respiratory consultant has been on annual leave and his juniors are doing their best but I feel they have not looked at my husband's previous and complicated history. They are never there when I visit so have been unable to speak to anyone other than the nurse caring for him on the day. He had a very bad night last night with sats dropping to low 80s despite oxygen - will see what today's blood test shows. After two weeks in hospital with what, at the time, appeared a relatively minor infection, and we are still no further forward. Just for info, DH had been nebulising colomycin at home twice a day for three weeks prior to this admission!!
Just out of interest, do you use a filter on your nebuliser to stop others inhaling the colomycin? We were given a hose to put out of the window and it really is a nuisance - I think someone said you can attach a filter to the nebuliser to avoid this!!
Don’t get me started on junior doctors! I have two respiratory doctors one that deals with my Vasculitis/lungs at addenbrooks and one in my local hospital who specialises in Bronchiectasis. The idea of having the two weeks of double iv antibiotics was to hit the pseudomonas hard and then the colomycin is to keep it at bay. It would seem that one antibiotic isn’t doing the job for your OH. I use the nebuliser in a spare bedroom away from everyone else. I wasn’t given anything to vent with just told not to do it around others. I’m sorry that this isn’t much help to you as you are stuck with your husbands doctor whilst he is an impatient but perhaps when he’s out he can get a referral to one that specialises in Bronchiectasis.
I agree with everything Mooka says.Also, as a very longstanding bronch it seems very obvious that the tazocin is not doing the job and it is meropenem that is required. The obvious pointer that these docs know nothing about bronch is their stopping of the antibiotic because they ‘want to keep something in reserve.’With bronch that is nonsense. It is more important that the dose and length of the course is sufficient to knock the bug on the head very heavily. May I suggest that to get yourselves in charge you look in your area for a genuine bronch specialist. Usually at a big teaching hospital. Take the name to your GP and insist on a referral, telling them that the current treatment is a shambles. Goodness knows how this hospital stay will play out. They are making a marathon mess out of what should have been a straight forward treatment.
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Thanks. I dont think they wanted to give him meropenem again as his body might get used to it and then not have a back up if he needed it in the future!! Unfortunately we are 1.5hrs away from the nearest specialist centre and he is rarely well enough to make that length of journey of late! Catch 22!!
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The fact that the tazocin is not doing the job makes the case for meropenem. Their reason for witholding it when it is obviously needed does not hold up when dealing with bronchiectasis. It has to be the right antibiotic in the right dose for the correct length of time. Otherwise the bug festers away and simply starts breeding again. This has been happening with your husband. He really does need a bronch specialist - however you get him there. Proper treatment and management can prevent hospitalisations and reduce the frequency of visits in the long run. Messing with bronch is not an option and anyone who does not know what they are doing is doing just that. I may sound hard but I have been at this game a very long time.
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Oh thank you for your wise counsel. Just been back to visit and he really is not good - today's bloods showed CRP still rising but no doc in sight. Spoke to nurse in charge and she has put a call in for a drug review - after I told her what had happened!! I despair!!
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I do hope that this gets sorted out. Your husband is very lucky to have you to fight his corner.x
Update: last night they started the meropenem!!! Fingers crossed for improvement now. 😁
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My Dad is really bad at the moment he is breathing so hard even at rest ,and coughing so much .He has been on antibiotics and steroids
My father had a severe covid infection, are these post-covid symptoms normal?
Saddest news ever 
Pseudomonas again
Yet another infection 
