Antibiotic resistance
Hello All!
Hope you’re keeping well! Have not been on here for some time, but seeking guidance from you kind people once again please...
My Dad’s recent sputum sample has revealed a resistance to Amoxicillin - is this something I should be worried about please?
No you don't need to worry. Amoxicillin is one of many antibiotics and a sample report saying that he has a resistance to it simply advises the doctor which antibiotic to prescribe that will treat the infection.
This is common.Amoxicillin & trimethoprim have been so overused many are resistant to them.Many other antibiotics available,more tailored to individual requirements. Good luck!🤞
Thank you very much 😊
With the caveat that I’m not medically qualified. As per other replies, antibiotic resistance is (unfortunately, increasingly) common, but not necessarily something to worry about. Some bacteria are naturally resistant to certain antibiotics, for example, a common, problematic bacteria in some lung conditions, called pseudomonas aeruginosa, is naturally resistant to every oral antibiotic other than one called ciprofloxacin. Amoxicillin has quite a narrow spectrum of effect on lung bacteria, so there are quite a few known or likely to be naturally resistant to it. As Littlepom says, in certain lung conditions it’s rarely prescribed as a result, although believe I’m right in saying that it is fairly routinely still used in copd. In addition, though, bacteria can also acquire resistance, either whilst in the lungs as a result of exposure to an antibiotic and learning how to stop it from working, or in the environment. This is linked to the inappropriate overuse of antibiotics for viral infections, and the lack of development of new drugs over the last 50 years. When people fail to finish a course of antibiotics as prescribed, often because they feel better, that’s one mechanism by which bacteria frequently develop resistance.
Whenever a bacteria is isolated from a person i.e. from a sputum sample, as well as identifying which bacteria it is, the lab test it against a selection of around 8 to 10 of the most commonly used and generally effective antibiotics. This is primarily done to identify which antibiotics should (and I’ll get on to the word should in a minute) be effective in eradicating the bacteria and need to be prescribed to treat it. It can also help properly identify certain bacteria, though: the one I mentioned above, pseudo, has a very nasty doppelgänger called burkholderia cepaecia, that can infect people with certain lung conditions. Because they can look so similar under the microscope, the resistance profile helps separate the two - b. cepaecia is naturally resistant to an antibiotic called colomycin (colistin). If a sample grows what looks like pseudo, which is normally highly sensitive to colomycin, but the profile shows resistance, the sample automatically gets sent to a unit at the Colindale national lab to confirm which it is and thus make sure the appropriate treatment regime is given.
With regards to my should comment above, sensitivity profiles are only ever a guide. We don’t quite understand how, but we do know for a fact that what a bacteria cultured in the lab (in vitro culture) appears to be resistant to and whether or not an antibiotic works in the body (in vivo culture) are sometimes two very different things. Treatment can often be started empirically for lots of infections, meaning antibiotics are given before culture results are back; if a culture sensitivity profile comes back saying that a bacteria is resistant to an antibiotic currently being given, but the person is improving, then treatment should usually be continued unchanged. Conversely, if a profile says a bacteria is sensitive to something being given but the person is failing to respond, the antibiotic should be changed to something else that the report indicates sensitivity to. You can also have different pockets of the same bacteria within the lungs that have different antibiotic sensitivities, depending on the circumstances.
Bottom line is that resistance is commonplace for a number of reasons, including as a naturally occurring phenomenon. In lung conditions, over time and repeated exposure, particularly in someone with a chronic infection (so one that can’t be completely eradicated anymore, only managed to keep numbers down), you would expect to see increased resistance to antibiotics. The time to worry is when a bacteria is cultured showing resistance to most (or all) of the antibiotics we would normally expect to work.
Hope that helps.
Charlie G, I am blown away! You say you are not medically trained, but maybe you should be with that knowledgeable advice. Thank you so much 🙏🏻
I am impressed by the number of users on this site, and I really do feel that users feel supported by others and their experiences. Personal experience speaks volumes in these forums, and I think it is a very positive support platform where users can express their fears, joy and sorrow, whilst being supported and supporting others. Please continue to provide such a good platform.
With kind regards, and well done!
Val Dodd
IVs rather than oral antibiotics. 
Too many antibiotics?...anyone using probiotics?
Your father is not being given the correct antibiotic for whichever bacteria is in his sputum. I don't know which condition he has but amoxyl is about as useful as a packet of smarties in conditions such as bronchiectasis. The GP should send off a sample and prescribe him the right antibiotic in accordance with what comes back. Quite honestly the GP should know this.
Thanks Littlepom! Our GP Surgery have done very little to manage my Dad’s COPD other than to give him an inhaler.
Truth be told we had always just accepted he has a cough and wheeziness attributed to asbestos in his lungs from working in the building trade. It wasn’t until my Mum was diagnosed with COPD, after being hospitalised with COVID, and battled a year of chest infections that I was at my wit’s end and discovered our Local Respiratory Nurses. They have been amazing and it’s them who have been helping me to get my Parents on the correct inhalers and have sputum samples tested.
I just feel bad that my Dad has been suffering unnecessarily all this time with persistent coughing. But the Doctor has finally prescribed some other antibiotics and together with the carbocisteine tablets the Respiratory Nurse got him started on I hope he will at long last get some proper relief and maybe a decent nights sleep (for all of us 🤞🏻)
I can’t understand why your father has not been referred to a respiratory consultant years ago. COPD and asbestos lung disease are two very different things and require different management to give the patient a quality of life. Your father badly needs a proper diagnosis so that his needs can be met and his suffering eased. Asbestosis in particular has its own specialists and departments. I’m afraid that we put far too much trust in GPs who are woefully badly trained in lung conditions. Having 72 years of bronchiectasis I know this only too well. Also, your father needs the equipment of a large hospital (ct scans, extensive spirometry) to diagnose properly. A respiratory consultant will advise your father’s GP on his proper treatment, rather than the hap hazard prescription of inhalers and antibiotics that has been going on for far too long. You need to insist, as a matter of urgency, that your father is referred to a really good respiratory consultant at the respiratory department of his nearest big teaching hospital. Don’t take no for an answer.
Littlepom, thank you so much for the great advice and support! I will get on the case - thank you!
Please stay well and take care 😊
BTW if your father does have asbestos related lung disease there is a lot of support available to him. My friend was diagnosed with this and the asbestos society have accessed benefits, a lump sum and a blue badge for them. And of course, they are now getting the right treatment. So it is worth getting it sorted out.