When my husband was diagnosed with Bronchiectasis he was told he would be susceptible to chest infections. He had one about a month ago and now has another.
He has been taking Doxycycline since Monday but he is still very chesty. The course is 14 days so not sure when we can expect the antibiotics to start working.
Any advice would be most helpful given that it is difficult to contact drs now until Tuesday.
Hello and welcome. I'm sorry to hear about your husband's problems. For the moment I can only suggest that you contact 100 if you feel he needs to be seen. They just might refer you to a doctor who might prescribe a stronger antibiotic. Unfortunately a sputum sample is the surest way to find out just which nasty bug is causing an infection and they can take several days, or perhaps more than 1 sample to get a result. In the long term he should be offered pulmonary rehab, which I found a great help. I had a bad chest infection not long after diagnosis and was prescribed Carbocysteine to be taken twice daily and Azithromycin 3 times a week. I haven't had a bad infection since. Unfortunately many of us on this site have found that we have to be persistent in asking for what we need, as medics do not know as much about bronchiectasis as they should. Best wishes, xxx
Thank you for your reply. My husband is taking carbocisteine 3 times a day . They did take a sputum sample at the drs on Monday so may get the results next week. Once again, thank you for replying.
Fingers crossed that the sputum sample gives a result. It sounds as if your surgery is on the ball, thank goodness.xxx
please complete the course,at present ive also got chest infection diagnosed by sputum test,took 14 days doxycycline no improvement,took another sputum test in last week,at present on amoxicillin 500mg for 14 days awaiting results .It does take awhile for antibiotics to work at times .Fingers crossed you get sorted.Have also completed pulmonary rehab course which is excellent,interesting thing was i was the only one with bronchiectasis on the course ,and they only have one patient on the latest course,probs due to the length of time we all get diagnosed.good luck x
Thank you for your reply. My husbands drs surgery have been very supportive with same day face to face appointment. It’s also very helpful to share experiences in this forum. Again, thank you.
I have COPD and our rescue packs contain not only antibiotics but also steroids , i gather that the steroids support you until the anti-biotics get working.
Thank you for replying. My husband had steroids last time but he has heart problems so the cardiologists don’t like him taking them. Admittedly combined with the antibiotics they did help to clear the infection and he felt better when taking then. Will see what next week brings.
Hi - sorry to hear your husband’s unwell. Is he doing daily airway clearance? I have bronchiectasis too and find that it helps me to clear infections more speedily. Before I was diagnosed, when I didn’t know about airway clearance, I used to find that doxycycline would make me feel better after about 5 days but that the chestiness would linger for a couple of weeks at least. I hope he feels better soon 🤞🌷x
Thank you for your reply.
Yes he does his airway clearance at least 3 times a day. The respiratory nurse has also left a n AerobiKa device for him to use but because of other recent health issues has not demonstrated it yet.
There are a lot of infections about at the moment due to children being back at school but we haven’t knowingly been in contact with any.
I presume he was given those antibiotics after sputum test. That's usually the way I find out which bacteria is the problem and which antibiotic is best. Having said that I have experienced 10 days passing before the antibiotics started to kick in. I find keeping hydrated, active and getting good rest helps as well as making sure my chest is clear as possible but we are all different.
If I was in his shoes and had no improvement after 10 days I'd be contacting my respiratory clinic or GP .
Thank you. He was given the antibiotics the same day as the sputum test, a week ago. Hopefully he will get the result’s for of his sputum test next week and see where we go from there.
Thats my experience . I present at doc with chest infection and based on previous history he will prescribe but sometimes a week later he will phone and change the medication based on known results.
Results are usually in within the week so he could phone in to GP tomorrow ? Good luck.
I have bronceactsis and asthma, has your husband taken in a sputum sample to make shore he is taking the correct meds for the infection he has. I have been swoped a few times doing this, my rescue pack is no co-amoziclav works a treat. I cant take Doxycylin does not agree with me. Good luck, take care and stay safe.
Thank you for reply and good wishes. The sputum sample was taken Monday at the same time he was given the antibiotics by the doctor. We have to wait for the results.
I’m sorry to hear about your husbands chest infections. I too have bronchiecstasis and had many chest infections. Doxicycline didn’t work for me, but my consultant put me on another antibiotic, azithromycin, as a prophylactic. I take it three times a week and have only had one chest infection since. This was the first year I started taking them, when th dr said stop taking them in the summer because ‘people don’t get chest infections then!’
Sorry to hear that. When I was diagnosed 11 yrs ago I had chest infections, one after the other. The consultant put me on a daily azithromycin table(prophylactic antibiotic) but I couldn't tolerate it so reduced the dose to 1 tablet 3x weekly.
I was much improved after that though it is a constant battle to clear the mucous away. I take 2x2 carbocisteine daily & use a 7%saline nebuliser a. m & pm behore I lie on the bed for 20 mins & husband pats my back to try to shift it.
You do learn to live with it & get into a routine. Good luck!
It’s early days for my husband so we are still in a learning curve. Very grateful for all the advice and experiences from you all. Thank you.
it’s likely the first course of antibiotics didn’t clear the infection properly and it simply came back again. There’s little point in keep taking the same antibiotic if it’s not working for your husband. If it keeps on happening get in touch with his consultant. GPs know little about Bronchiectasis and are a bit lost when it comes to dealing with it. My sputum samples often didn’t show anything even though I was clearly very poorly at the time. I hope he shakes this off soon.
My husband is no longer seeing a Consultant following his diagnosis. He has a community respiratory nurse who is due to come and see him next Thursday and his asthma nurse and doctor. His doctor seems quite knowledgeable about the condition.
It can take a good few days to analyse the sample, and then to suggest the best antibiotic to sort the bug. Occasionally the bug may need an Intravenous AB to knock it out. Doxycycline is a broadband AB, which may do the job, but may not, and he'll have to change to the right one. Hope it goes well.
Thank you. Hope we get it sorted next week.
Has your husband got stand by antibiotics which he can start on if he feels he has an infection without seeing a doctor, say on a weekend. The minimum dose is 10 days for anti bio’s (as per N.I.C.E guidelines I understand). If you see a doctor he may give 14 days. I always think when you start the antibio course there is an immediate impact but this may not last & I have known not to feel fully recovered from the infection until the 9th or even the 10th day of 10 prescribed. So, hang in there & best of luck to his recovery.
Thank you. My husband is still coming to terms with his diagnosis and getting to know the difference in the coughs and his asthma. We have now got a 14 day course of antibiotics as standby. Our community respiratory nurse is visiting on Thursday so we will have a lot to discuss with her from all the input this forum has given.
Bronchiectasis simply means " damage to the lungs". There are very many causes, and up to fifty percent of sufferers will never know how or why they developed bronchiectasis. This damage is irreversible at this time. A good percentage of people live and die, never knowing that they had bronchiectasis and a vast percentage live a "normal" life span. Once you know you have bronchiectasis, the main aim is to keep your chest as clear as is possible, this can slow or even stop damage worsening the situation. When given a course of antibiotics, an improvement can be felt after only three or four days, but never stop taking the antibiotics until the end of the course. Steroids are given in the rescue pack, as for a minority can have extreme difficulty in breathing, to the point that their life is threatened, if difficulty in breathing is not experienced then steroids would be innapropriate. I have a large amount of medication and daily treatments to keep me well, it can take me four hours a day with chest clearance and self physio. There is a very good site where a vast amount of knowledge is available from thousands of people from around the world, link below;
bronchiectasis.info/default...
Please know that there are many that suffer from bronchiectasis and still do things like raise a family, do a full time job and succeed to fulfill their ambitions in life. CF bronchiectasis is the other end of the scale and, although new treatments are extending their lifespan, they are usually quite badly affected by the time of their treatments take up on a daily basis.
I wish your husband and yourself the very best, good luck.
PS I am not a doctor or a healthcare professional, thses views are my personal views based on my own life experience of bronchiectasis, I am now 73 and was diagnosed 53 years ago, I am still going strong!
I have Bronchiectasis but I have not been given a rescue pack. Could you tell me what’s in yours please.
With the caveat that I’m not medically qualified. Unless you also have another condition like copd or asthma, or you have known problems with a fungus called aspergillus, patients with bronchiectasis should have a two week course of suitable antibiotics in the cupboard that they can start in the event of a change in sputum and respiratory symptoms whilst waiting for sputum culture to come back. The phrase rescue pack more usually applies to COPD (and sometimes asthma) where patients will keep a short course of both antibiotics and oral steroids at home. Steroids are not routinely recommended for use in bronchiectasis.
Thank you. Very useful.
Hi, presently I only have Co-amoxiclav which is a combination of 500 mg Amoxicillin with 125 mg Clavaulanic acid. I also used to have 30mg prednisolone for seven days then reducing 5 mg every three days to zero. I developed adrenal innsufficiency so spent 4 years on reducing doses of hydrocortisone until I was well again. I take, routinely, a tiny dose of prednisolne, 5 mg per day.
With the caveat that I’m not medically qualified. I’m sure Hidden or cofdrop-UK can explain why a lot better than I can, but my understanding is that steroids are not a standard treatment for bronchiectasis unless there are other comorbid, underlying issues like asthma or COPD present, or unless ABPA (allergic bronchopulmonary aspergillosis) is an issue. Current best practice that should be followed in the UK for managing bronchiectasis can be found in the British Thoracic Society guidelines available here:
brit-thoracic.org.uk/docume...
In relation to steroids, the guidelines state the following:
➢ Do not routinely offer inhaled corticosteroids to patients with bronchiectasis without other indications (such as ABPA, chronic asthma, COPD and inflammatory bowel disease). (B)
➢ Do not offer long-term oral corticosteroids for patients with bronchiectasis without other indications (such as ABPA, chronic asthma, COPD, inflammatory bowel disease). (D)
In terms of short courses for exacerbation self-management, my understanding is that steroids are not considered part of the recommended bronchiectasis rescue pack unless a patient has another underlying reason to keep a course at home e.g. because they also have COPD, where corticosteroids do form part of the self-management plan. For those patients with bronchiectasis without any comorbidities, the only thing should be routinely kept at home to be commenced with an exacerbation, is oral antibiotics appropriate to the person’s known culture history. Given that your username is wheezybronch, I’m guessing that would explain why you personally may need steroids as part of your management plan, but many people with ‘just’ bronchiectasis don’t wheeze even during exacerbations, and therefore don’t use steroids.
Hi, you are correct about the guidlines, however, bronchiectasis (non CF) treatment is far from standardised and is mostly "second hand"from CF bronchiectasis, COPD, and Asthma treatments. It is not only steroids that are not routinely offered but also daily preventative inhaled anti-bioticcs, inhaled salbutamol, oral Uniphyllin, inhaled Ipratropium and to a lesser extent, Azithromycin (three times a week), all of these form part of my daily treatment. I have not been diagnosed with COPD or Asthma although, I have had many bouts of Aspergillius Fumigatus. I take Fostair and Mometasone, which both have a steroid component. I believe that I have these non"standard" meds because I suffer from inflammation of the airways, even when no evidence can be shown that I have an active infection. I am colonised with Pseudomonas Aeruginosa. Of equal importance, if not more important is airway clearance, exercise and keeping active and happy.
Not disputing your treatment at all, and I’m well aware of the crossover between cf and NCFB treatment as my daughter has fairly severe cf, just saying that steroids are not standard bronch treatment unless there is a clinical need for them. If you’re wheezy, you need them, and a history of aspergillus and/or ABPA requiring treatment would support that, but the takeaway from all my reading over the years is that many people with purely bronch and no other comorbidity don’t benefit from them because their inflammation levels are low, and/or predominantly neutrophil driven: my understanding is that neutrophil production increases with corticosteroids, so they have little effect for a lot of people in the absence of inflammation that will respond. Daily inhaled antibiotics are standard in bronch where there’s chronic pseudo, and prophylactic zith is now increasingly common across the spectrum of obstructive, productive respiratory diseases for its (not yet understood) anti-inflammatory effect and subsequent reduction in exacerbations if it works for the individual in question. Not everyone gets benefit from it. I couldn’t agree with you more about airway clearance and staying active and happy, though - long may that continue for you.
Thank you for your reply and best wishes. Much appreciated.
Hello sorry to hear about your husbands problem I think everybody on here is treat a slightly differently bronchiectasis I had antibiotics for year, taking 1 tablet 3 times a week , And for an exacerbation I always keep a emergency supply of a strong antibiotic when needed for two weeks at a time .I actually don’t send any samples only 2 random ones per year ,I had a lung wash beg of year,so nice to be able to breathe if only for few months, nebulous drugs & nebulzer kept at home and steroids, so this is how I cope, avoiding people in the colder weather and always wear a scarf to keep my chest warm. I think as time goes on your husband will be able to understand what he needs to stay in the best of health, I am under a consultant so it may be worth asking for a referral, I wish you all the best .x
Thank you for your reply. Our community respiratory nurse came round today. My husbands sputum test was clear but he still has congestion. His oxygen level was good. She contacted his doctor and he has prescribed a 5 day course of steroids and doubled the carbocisteine for now. His nurse has regular updates with the consultant and he would see him if it was felt necessary. It seems like they are well organised.
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