Blood mixed sputum not going away, have bronchiectasis

[Warrior4104]

I had visited two days before to the doctor as I was having a bronch exacerbation. When I mentioned blood, he gave tranexamic acid 500mg which is an anti fibrinolytic. Rest of the medicines are inhalers, septra ds antibiotic, etc

Despite of taking tranexamic the sputum is still red or rusty and the bleeding isnt going away. It is not in a significant amount but whatever it is freaking me out.

When I had my first diagnosis I had blood mixed sputum and was prescribed the same tranexamic and it worked in a single dose but now I’ve been taking them for two days and no result

Maybe Im rushing towards the recovery or there is some problem that the bleeding isnt stopping. The doctor prescribed this tranexamic for 5 days. 2 days already over but no result

should I wait as the blood is in moderate quantity but I get panic after seeing it

[teddyd]

I personally would not wait. I would call 111 for advice. They can point you in the right direction.

[Hidden]

I see that you are in the UAE. I have had bronchiectasis for 69 years. Bleeding can occur during a bacterial infection. It usually resolves itself with the right antibiotic in a high enough dose for at least 14 days. I know that seeing small amounts of blood ( it appears to be more than it actually is) is frightening but it is not dangerous. I have only had tranexamic acid once when I had a haemorrage brought on by a heart drug which affected the veins in my lungs. I am more concerned that you are being treated with the wrong antibiotic and probably need to find a respiratory consultant who specialises in bronchiectasis. There are many antibiotics for bronch, including 2 week courses of oral antibiotic ( septra is very old fashioned and does not always work on the bugs which we get in our lungs), long term azithromycin to keep down inflammation, inhaled antibiotic to keep down bacteria and IV when the other methods are not proving effective.As you have only been on this treatment for a couple of days you need to do the full course to find out if the antibiotic is working.

I don't know how good health care is in the UAE but I do suggest that you find a true bronch expert to help you to manage this complex condition.

[Warrior4104 in reply to Hidden]

yes I had my sputum culture and it showed staph aureus and pseudomonas. This bug staph aureus was susceptible to septra so the doctor prescribed it. And yes I am receiving a high dose of it, double of the standard dose for 14 days. He also said something about inhaled antibiotics i.e colistin. We don’t have it available here so I’ve to wait until I get it.

Ive contacted the doctors office lets see what he suggests further

Thanks

[Warrior4104 in reply to Hidden]

About tranexamic acid, he didn’t wanted to prescribe but as I was so scared and freaked out I insisted him to prescribe it. I am afraid of what happens next. When I mentioned about long term azithromycin doc said colistin is better wit fewer side effects but the thing is colistin is not available in my area

[Timberman]

Can you get a sputum sample tested? It sounds more to me like an infection - all tranexamic acid does is help your blood to clot; more often used for nose bleeds and heavy menstruation. I note where you live - any chance of seeing a different doctor?

[Warrior4104 in reply to Timberman]

I had the sputum culture it showed staph aureus and it was susceptible to septra hence the doc prescribed it. I am unable to consult any different doc as there are only two respiratory consultants near me and both of them agreed that this treatment is optimal. Healthcare sucks here. I am freaking out of tension what will even happen to me if things progress like this😭

[Timberman in reply to Warrior4104]

Hi - I well understand your worry and wish I could help more. I too have had staph aurea; it is a nasty infection. Mine was cleared with vancomycin. I looked up the best treatments for it and found this:

Antibiotics commonly prescribed to treat staph infections include cefazolin, nafcillin, oxacillin, vancomycin, daptomycin and linezolid. For serious staph infections, vancomycin may be required. This is because so many strains of staph bacteria have become resistant to other traditional antibiotics.25 May 2022

Staph infections - Diagnosis and treatment - Mayo Clinic

I also looked up septra, which I had not heard of, and found this:

Septra (Antibiotic): Uses, Dosage & Side Effects - Drugs.comdrugs.com › ... › Septra

3 Mar 2021 — Septra is an antibiotic containing sulfamethoxazole and trimethoprim used to treat ear infections, urinary tract infections.

‎Septra Dosage · ‎Generic Septra Availability · ‎Septra · ‎Drug Interactions

[Hidden]

It does sound as though your doctor knows what he is talking about and given the staph showing up in your sputum is giving you the right antibiotic in the correct dose for 14 days. Although I do think that long term azithromycin would help deter exacerbations with this bacteria. I took it for 5 years with no side effects. Many people find it useful. Inhaled colistin is really used as a prophylactic against pseudomonas which you do not have in your sputum.He is right. You don't need tranexamic acid.. it is the infection which is giving the blood. It really isn't much in the scheme of things and the rusty colour means that it is old blood. You will need to accept that with bronch this can happen and try not to panic. For yourself, you need to take control of your daily management of the condition and make sure that you empty your lungs of fluid scrupulously every day. You can find breathing exercises on You Tube to help you do this. Also, nebulising isotonic saline helps to make the sputum runny so that it is easier to get out. I nebulise salbutamol to open the airways and then saline and this helps me to empty my lungs.

Freaking out is not going to do you any good. You are living with this condition and it is perfectly possible between your doctor and yourself to get control of it and to live a very full life. It is horrible that you are isolated out there. In the 1970s I lived in Beirut where nobody knew anything about it. I had a baby whilst living there and had to manage my condition completely alone. I used to have to decide which antibiotic I needed and go to the pharmacy to buy them. So I do understand how you feel.I am 73 now and still doing lots. We are here to support you.

[Warrior4104 in reply to Hidden]

I am pseudomonas colonized and this staph is new to me… Thank you so much little pom I appreciate your advise. Its been 6 months I’ve been diagnosed with bronch.

[Hidden in reply to Warrior4104]

Slowly the picture comes out. 😊 ciproxen is the oral antibiotic against pseudo. It depends which of the two bugs is actually giving the problem now. There are bronchs on this forum who successfully keep both bugs down by taking azith and nebilising colistin together. If your doc can get hold of colistin for you maybe they would like to try that. Bronch is complex and we are all different but you will get there.

[Batman1313]

It worries me the GPs do seem seem concerned about blood.

[eleanordigby in reply to Batman1313]

Yes my GP freaked out when I first mentioned it but the consultant wasn’t at all bothered. It’s fairly common in bronch and most GPS know nothing about our condition

[eleanordigby]

Firstly, don’t worry about the staph aureus, it’s a very common bacteria & there are a number of oral antibiotics which are effective against it. It can be persistent, but you will get rid of it. From the colour, the blood seems to be old stuff, most likely the result of inflammation from infection as Hidden says. If your consultant isn’t worried about it, you shouldn’t be either.

Pseudomonas is almost impossible to eradicate but it can be controlled, and nebulised colistin (colomycin) is great at doing this. There are other nebulised antibiotics eg Tobramycin, Cayston, which also work but you can only take them on alternate months, and colistin has fewer side effects. Whilst you wait for that, there’s an oral one, ciprofloxacin, which can deal with exacerbations.

It sounds to me as if your consultant knows what he’s doing.

[Warrior4104 in reply to eleanordigby]

The sputum has a tea pink appearence… what is even happening with me i don’t understand. I mentioned my doc he said keep taking tranexamic and once the antibiotic kicks in it’ll get better. It’s been 4 days I’m afraid this might lead to a bigger complication

[Shonkie]

This may be quite wrong but I once had serratia marcescens which produces a red brown sputum, very disturbing. This should however be found by a sputum test. Hope things go better for you, you definitely have my sympathy.

[Warrior4104 in reply to Shonkie]

Nah I’ve had the sputum culture it showed two bacterias

Pseudomonas and staph aureus

Maybe its really the inflammation causing it or Its over for me i am just so done

[shakhnozah]

How are you doing now and has it been cleared? I have had very similar spotum since January 2022 up to present. It comes and goes. Some days every morning and sometimes it is gone for 10 days and then back again.