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Chest Infection

BP135
BP135

I've posted on here a couple times about reoccurring chest infections. This is my third winter of suffering with a tight chest, being unable to exercise, breathlessness and excessive sputum. I was referred to a respiratory consultant over a year ago who I saw a few times regularly while she changed my asthma inhalers and put me on motelukast then my apps changed to 4-6 monthly. I thought all of this helped at first but I've since realised that my infections usually start as the weather changes in September/October and are almost constant until May when it warms up again.

This year my GP has sent away 2 sputum tests for me, both times they've come back with bacteria and I've been given co-amoxiclav and pred. I'm currently on my 4th lot of antibiotics since September and each time I'm on them the phlegm goes away or gets better for a few days then comes back again. They are saying it's the same bacteria. Why wont it go when I'm taking the antibiotics they've suggested?

I have tried to get in touch with my respiratory consultant but her secretary just says she doesn't have any appointments, I've been trying since Dec, due to see her in April so might as well give up now and wait until April.

I just wondered if anyone else has experienced this or has any ideas of what it might be? I've installed a PIV unit in my house thinking it was the damp patch in my wardrobe causing these problems (my asthma started worsening every winter once I moved into the house I'm in now), the humidity has hugely improved in my house but my asthma still hasn't.

I have queried Bronchiectasis with the resp consultant but so far she hasn't done any tests. She tried to discharge me the last 2 times I've seen her.

My husband is encouraging me to go private, as I have no issue spending out when it's my children's health, but when it comes to mine it feels like a waste of money! I am not having trips to A&E with my asthma, just haven't been right for so long. I'm such an active person usually and it really gets me down when I can't exercise.

I suppose this is more of a rant really, but if anyone has bothered to read this far please let me know if you have any other ideas for me!

Thanks!

35 Replies
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Hi, since they have identified a bacterium that is causing the infections, it may be worth asking for a different antibiotic - co amoxiclav is a broad spectrum antibiotic but there are usually several that will work for specific bugs. It may also be worth asking about taking the antibiotics for longer (e.g. two weeks rather than 1). I have a similar issue, except that they have never identified what is causing my chest infections. Good luck.

BP135
BP135
in reply to Bluecat99

Thanks. I just assumed that co amoxiclav was for the specific bug they found, i thought that was the point of doing the sputum test. Thats frustrating!

Thanks for the advice. I will call the Dr today.

How long have you been having your infections for?

Hamscoul
Hamscoul
in reply to BP135

Just to say when a bacteria is identified the report will list what the bacteria is resistant to and what will kill it. There can often be more than one antibiotic that the bacteria is sensitive to. So might be worth asking that.

I had a similar problem but ended up with a permanent phlegmy chest. Eventually the consultant prescribed Azithromycin for 4 months.

I had to have tests prior to the treatment to ensure I wasn't carrying a bacteria that would cause complications.

I have had a clear chest for almost two years.

The treatment was developed in Japan, I believe, which was then picked up by Australia. Eventually it has been approved in the UK. And there are no steroids involved in the treatment apart from the patient's usual inhaled steroids.

I can have an annual winter course, if required, as I responded so well to the treatment, however, that hasn't been necessary.

My consultant explained that recent thinking, after good results, is that long term antibiotics are a better treatment than a combination of repeated short-term antibiotics plus steroids in some cases of asthma.

Hope this helps.

WrenJen
WrenJen
in reply to Poobah

My daughter had to have a similar treatment after a year long episode similar to yours. She had a constant chest infection and gp kept prescribing amoxicillin. Consultant gave her three months of azithromycin and it all calmed down. Now it’s on her records to go straight to that treatment if she has similar issues again. Hope you find something that works.

BP135
BP135
in reply to Poobah

Wow thats great! Thanks for replying. I will discuss this with my doctor. I have been worrying that I might have bronchiectasis and this will just be how I am all the time now. So this gives me some much needed hope. Thank you. I hope you remain phlegm free!!

DenBoy70
DenBoy70
in reply to Poobah

Hi Poobah,

I have just been prescribed a 6 day course of 500 mg of Azithromycin which I can see from your post you were prescribed the same type of medication.

The information that comes with the medication refers to a recommended dose of 500mg for 3 days or a 5 day course starting with 500mg and tapering to 250mg.

I see that you were given a 4 month course, can you tell me what strength of medication you were taking daily.

Poobah
Poobah
in reply to DenBoy70

As it was two years ago unfortunately I can't remember. However, I took one dose on alternate days.

I've not heard of tapering antibiotics but things are definitely changing on this front. My consultant also explained that some asthmatics respond better to antibiotics than steroids so we may see the end to the usual steroid & antibiotic combo in some cases. But I expect this to be consultatant led.

I'll see if I've kept any hospital letters that refer to the dosage of Azithromycin.

Poobah
Poobah
in reply to DenBoy70

Unfortunately just reviewed my hospital letters but none of them stated the actual dose of Azithromycin. Not helpful for the GP!

DenBoy70
DenBoy70
in reply to Poobah

Hi poobah, thanks for looking.

I was curious as both yourself and WrenJen were both prescribed treatment for a number of months as opposed to the patient leaflet which indicates a very short period.

I’m glad it worked though.

Poobah
Poobah
in reply to DenBoy70

I just Googled the dose for long term courses and the suggestion was 250mg three times a week for starters but various factors have to be considered. Some doses are 500mg and can last up to a year. So there is no standard treatment by the sound of it.

Trouble with Googling stuff is the deluge of information, so much of it technical and difficult to understand.

I do hope you find a resolution soon.

I have also spent almost every day since sept not feeling great with a crap chest. Had 2 lots of antibiotics and two lots of pred (currently on them now).

I havent been able to run properly all winter and its getting me down. I kinda assumed it was typical winter and it didnt occur to me that there was much they could do... but hearing about that long term antibiotic is interesting. That or emigration to a warm climate!!!!

So frustrating. Bring on spring. Xx

BP135
BP135
in reply to Cerimorris85

I have been thinking the same!! Feels like it would be easier to move my whole family abroad than get any answers from the doctors!

Hi,

I’ve been coughing up green phlegm for 2 weeks now, my doctor put me on a 5 day course of amoxicillin which haven’t resolved the problem and has now given me a second 5 day course.

The doctor checked my chest and said it was clear and so he thinks it is a low grade infection (whatever that is). I’m going to ask for a sputum test and go from there.

I am looking at going private and worth considering, an initial appointment usually costs around £200 and follow up appointments a little less. At least this way you get 30 minutes or so he have a proper consultation and can usually get an appointment in days. I look at it that it’s worth sending the money if it resolves the problem.

Hope this is of use.

BP135
BP135
in reply to DenBoy70

If thats all it is I wouldnt mind paying. I was looking into CT scans which can be £500-900 plus consultant charge and any other investigations they deemed necessary...but reading some of the replies I have had I am hopeful now it may just be a case of a long term antibiotic. Fingers crossed your Dr gets to the bottom of your issue!

DenBoy70
DenBoy70
in reply to BP135

Hi, I think I will end up on long term antibiotics as well.

Consultation charges are not to bad given you end up with a reasonable amount of quality time with a consultation and not the arbitrary 10 minutes with a doctor who’s so busy.

Yes tests can be quite expensive I think chest CT scans are nearer the £500 - £600 mark but you would only need one. Going private can be expensive overall and is a last resort,

Hopefully long term antibiotics are the answer for both of us.

Good luck.

To everyone who has posted on this subject. Maybe I'm lucky with where I live, but my respiratory team at our hospital were very good and I'm able to contact them via their nurses if I need to check on something or discuss an asthma related problem.

They took their time before prescribing Azithromycin, but once you've had it and it's been successful then it's on your records and available if required.

As the hospital team conduct research into asthma I volunteered to help. This proved very beneficial as suddenly I was monitored more closely. If you get a chance then definitely consider helping with asthma research. Some of the projects are just monitoring and testing, taking phlegm samples (phlegm also contains lung cells that can be examined). I skipped one project that involved taking lung biopsies.

And just recently they were looking for asthmatics who had been on oral steroids in the last year. I didn't qualify, thanks to the Azithromycin.

Rather than paying for private treatment is there a way you could sign up for research at a centre specialising in respiratory illness and also receive treatment there? From what I read on hear there's definitely a postcard lottery when it comes to asthma.

BP135
BP135
in reply to Poobah

That sounds like a great idea, it wouldn't work for me unfortunately as I work full time and have 2 young children so would not be able to fit it in at the moment.

The consultant herself at my hospital seemed brilliant at first, I think the trouble is I have seen her a couple of times in the spring/summer when my asthma is better so she thinks the medication has improved my symptoms, then I go downhill in the winter and can't get hold of her. She has a very difficult secretary who refuses to book me in for a sooner appointment and is quite sarcastic. My GP has written to her to ask to see me earlier but they still haven't sent an appointment though after 6 weeks. I tried to call yesterday and someone answered the phone and said both the consultants secretaries are on holiday so can I ring back next week. I assume I don't have an appointment as she should be able to tell me when it is if I do. I just feel so helpless and fed up. My asthma nurse and GP say they cant refer me for any investigation, it has to come from the consultant.

You are definitely right about it being a postcode lottery! I don't see it getting better any time soon either.

BP135, I know that you now have to wait to see the specialist in the spring but may be ask if you could ask her if you could have a winter appointment in the future. I would definitely explain that she is only seeing you at your best, or definitely not at your worst so access to effective and timely treatment is being thwarted.

All my tests were carried out by the nurses attached to the hospital team and they would then record the results before I saw the consultant. To be honest every time the consultant didn't examine me but made their decisions on what the nurse had written. If your hospital team has the same process I'm wondering if you could see the nurse now, have the tests but see the consultant as planned.

I know it's frustrating especially when the local asthma nurse hasn't got access to the digital testing items. Mine only has a peak flow and a resistance tube - nothing digital. Her appointment wait time is about 4 weeks, much quicker than waiting for a consultant. But I have seen the hospital nurse without seeing the consultant and then she has arranged a consultant appointment and suggested treatment. Not sure if that's just the way out hospital team works, but it's better than waiting months.

Hope you get sorted. All the best.

BP135
BP135
in reply to Poobah

Yes I definitely will do that this time. Previously I hadn't realised it was the winter weather causing the issue as my first chest infection 2.5 years ago that started this off started in August and then just continued for months on and off. The GP changed my asthma medication about 8 months later so it was spring time and I started to feel better. Then deteriorated the next winter, the following spring the consultant changed my meds again and I felt better so again thought it was the meds. It's only this winter I have realised it must be the weather. Sounds stupid now I'm writing it down!

I asked to see a respiratory nurse and my GP said the consultant also has to refer me to that team. Seems very odd to me. I feel as if I am under no ones care at the moment. That is another thing I will mention when I get to see the consultant because it sounds as if that saves a lot of time and works well for you.

Thanks for all of your advice. Stay well :)

Poobah
Poobah
in reply to BP135

Well you now have a good pattern of winter problems to demonstrate to the consultant they can't ignore it.

All the best & good luck.

For the last ten years I have had a brilliant lady doctor who as soon as the tv add about anti-biotics do cure cold would call me in and when doing a test on me always found that I had been infected with a chest virus.Straight away I would be put on a course of steriods.Usuallly it would be a reducing amount each day but it kept me healthy.Now I feel lost because she has retired and this year have been very ill for five weeks.Last Saturday had to use the 111 service ans eventually when the doctor came he said I had serious chest infection and gave me a course o fDoxycycline .Am afraid these tablets are no way as good as the Steriod medicin was which I JUST CANNOT rememberr the name right now

BP135
BP135
in reply to gordon292

Was it prednisolone? I have had these as a high does over 5 days or as a reducing dose over 3 weeks.

gordon292
gordon292
in reply to BP135

Thanks BP135 that was the medication she always prescribed for me and it worked every time.So thanks very much without it I am such a wreck this year and fear I will never pick up.

PS Second line should have read do NOT cure cold.

Hi, what you are describing is virtually word for word the symptoms I'm experiencing and the same time scale, I've had CT scans, Lung function tests etc and apart from the Asthma there isn't anything more sinister which is a relief but the problem of repeat infection still remains, I've just started my 5th lot of antibiotics since September and I know from experience it will all start again in a few weeks . My consultant thinks the problem lies in the low dose of antibiotics given everytime by my GP (usually Doxycycline) and by doubling the dose to 200mg a day for 7 to 10 days would get the infection out of my system instead of half cleaning it, my GP somewhat agrees with this but because the consultant didn't put it in his covering letter to the surgery he is reluctant to act on it !!! Which doesn't help my situation at all. On a plus point I see the consultant again in March and I will explain this to him then, in essence it may be worth informing your consultant about what antibiotics you are given and if they are good enough...hope this helps.

BP135
BP135
in reply to Billbodog

It's reassuring to know I am not alone. I haven't had a CT scan yet or any other tests, only sputum tests and an X ray. I am sick of taking antibiotics now as I suffer form side effects but if I could have one stronger longer does as you say and that finally knocks it out that would be great. It sounds like it makes sense to me. Very frustrating that the consultant didn't put that in writing! Now you are going to go back downhill until you can see them again and get the prescription.

Please let me know how you get on.

Billbodog
Billbodog
in reply to BP135

Hi, yes I definitely will let you know once I've seen him, take care

What bacteria has been identified? Please ring up Asthma UK Helpine their nurse specialists are fantastic, for some advice it may help frame the questions for your next appointment. I feel for you as it is very debilitating having regular infections. I’m unsure whether private would make a difference except getting an earlier appointment.

She didn't tell me. Until coming on this forum I have been plodding along taking no responsibility for my own health, just going with whatever the doctors say. I should of asked.

I tried to call the Dr's 5 times yesterday but could not get through, they are so busy. Will try again today to speak to the GP and try and get some answers. I also emailed the hospital yesterday to say I feel totally helpless because I can't see anybody about my chest infections. They have already replied and are looking into it so I'm hoping I will now be able to get in touch with the consultant. Any progress will do because at the moment I'm just going round in circles!

Thank you for your reply.

I’m exactly the same and I spend a fortune on natural supplements. Just today I’ve received colloidal silver which I’m using as a nasal spray and also taking internally. My asthma comes from my sinus. I’m hoping this is going to work! Try and research for yourself. Also look at natural antibiotics like grapefruit seed extract, oregano oil, olive leaf extract, garlic, propolis etc. Probiotics helpful too.

Hi I really feel your frustration as I am in the same boat.

With me they initially thought i had a chest infection , after couple courses of antibiotics then predisclone for 8 days. I then we for a chest x-ray (was all clear ) this was back in june 2016 , by the December I had no air feeling as well as the constant phlegm. I was then put on flutiform inhaler.

ive spent over 2 and half yrs coughing up green (sorry if tmi) and wheezing /cant lay flat because of this.

Fast forward to now the only reason I even found out back in july/aug that I have bacterial infection (was one infection then last sample taken is a second infection too ) and had 3 x 2 week courses doxycycline, last lot was 1000 amoxicillin 3 times a day for one week , and now just been given co amoxiclav another week, as infection is still there.

I thought mine was so stubborn because had it so long , maybe it is or maybe bacteria is a bugger to get rid of. Im angry it took so long for my doctors to look into this properly, it took me going to doctor one last time (was about to give up say this is my life now.

I went saw a trainee doctor and said im so sick of this please refer me to chest clinic or somewhere she asked if they had ever taken a phlegm sample (nope) the last doctor i saw said the next step is to put me on copd drug.

Turns out I have haemophilus influenzae and on last sample taken had moraxella now too. My doctors practice manager just ignores my calls than look into why no doctor bothered to even take a phlegm sample and honestly don't know if i will ever get rid of this. sorry to rant on your post lol, just saying i feel your pain and I really do hope they sort yours out soon.

Thats so annoying! I feel like I know much more a out asthma since being on this forum and I've had it my whole life. At least others can give us ideas of what to ask for.

I have another drs app on monday so I am hoping I can put some ideas to her and get the investigation moving. Some days I really don't have the energy to chase this up and kerp booking dr appointments. I am sure you feel the same.

Good luck. I hope they find something that works for you to shift it x

Polly44
Polly44
in reply to BP135

yes I feel the same and when I went to the doctors back in aug I was thinking right one last try then will just except this is my life now, you think cant be **** keep going to doctors eh. Im glad that time they finally looked into it or god knows where i would be now with these infections.

I wished i had come on here sooner so I maybe would have asked the docs to check my phlegm sooner.

That said and all Im reading it sounds like it would have been a bugger to shift anyway. we will get there in the end Im sure. for now we have to just gotta keep plodding along and pushing the docs eh ,not got much choice eh ha ha.

Im defo asking to be referred somewhere is this lot antibiotics don't work and same got some ideas like the Azithromycin. tc let me know how you get on :)

Hi everyone!

I went back to the DR's, found out the bacteria in my sputum...haemophilia influenza and streptococcus pneumonaie . Does this mean anything to anyone?

I see online and on here that people with bronchiectasis get haemophilia influenza. I have been saying all along that I think this is what I have but haven't been sent for tests yet. Do you know if you can get this bacteria if you just have asthma and not bronchiectasis?

I have the respiratory consultant this afternoon anyway so will push for tests. I complained to the hospital last week and suddenly there has been a last minute cancellation and the Dr can see me! Funny that!

Hope everyone is well. I am on a high just because I feel like I might finally start getting somewhere! x

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