British Lung Foundation
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Does anybody else find amoxicillin ineffective? I have Bronchiectasis

With a flare up I am always having to have a 6 day course of a so called super antibiotics. I read in a newspaper that a Prof Paul Little of Southampton Uni siad "Using amoxicillin to treat respiratory infections in patients not suspe cted of having pneumonia is not likely to help and could be harmful."

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40 Replies

My husband has had Amoxicillin antibiotic prescribed for him but they found out by doing a sputum test that the infection he had could not be treated by it, he has now, each time he starts being ill, to do a sputum test to determine which infection he has then they prescribe the antibiotic that is sensitive to that bacteria. This now clears the infection straight away, until the next time it happens and we have to start again.

Thanks. Unfortunately,my GP does not believe I need sputum tests yet. Saw him today and he has told me toleave off the amox. antibiotic and I can have the ones that work to keep at home. I think they startwith Az. To be fair out of the 5 docs he is the one who diagnosed after two years and he does take an interest. KatieJJ

How can he give you the correct antibiotic if he does not know what the bacteria is without doing a sputum test. How does he know that the one he gives you will work.

My husband has been in hospital a few times this year with pneumonia because the antibiotics our GP gave him, ( without asking for a sputum test) did not work. The specialist sent him an urgent letter telling him that every time my husband starts with an infection, he has to do a sputum test, take the emergency antibiotics he has at home and when the results come back change to the correct antibiotic.

Since doing this, and by being on the correct antibiotics, he has not been in hospital since, he was going in hospital every 6 weeks with pneumonia before this happened.

Most of us keep antibiotics at home to hit exacerbations as soon as possible. A sputum test cannot therefore be done before a prescription is issued. Any infection which continues would obviously be tested at some point.

Sorry to hear about your husbasnd being hospitalized. My GP has now changed my at home anti bios to Zithromax 500mg for 6 days. Luckily these have always worked so far. He says it it aint broke don't mend it. He has been very good to me. I know if they did not work he would then as he said would expect to have sputum samle taken Hope your husband keeps improving KatieJJ

My experience/thoughts are that amoxicillin is often prescribed if you have Bronchiectasis (or lots of other problems) but either not for long enough and/or not at a high enough dose that us bronchs need. Whilst the symptoms may be reduced the infection still lingers and just flares up again at the first opportunity. Azithromycin on the other hand is not used so freely so bugs don't build up a resistance to it.

I think that if you have bronch then you are supposed to see a consultant who would then instruct your GP to send in a sample before you start antibiotics, which could be changed depending on the test results. The BLF helpline might be able to advise you more around this area, but I envy the fact that you seem to have a caring and interested GP!

Take care

Beth xx

I am! I rely on him and the wonderful BLF helpline. I dread if I have to seem the specialist again (very cold and dismissive). I think Iam lucky so far other people seem so much more worse off. After being mis diagnosed 2 years (the inf would leak out of lungs and I would 3 months infs all around the body i am glad to have it semi controlled; Anyway thanks for the reply xxx

I find that amoxicillin has little effect when I get a chest infection. Even 3 weeks on 500mg four times a day did little to sort me out.

I have standby AB's, 2 weeks of one a day Doxycyclin 100mg. They usually do the trick, but I did have a 2 week run on clarithromycin for a change as I'd had Doxy 5-6 times in a row.

I've not had a sputum test via my GP yet, despite being diagnosed for several years. My hospital respiratory nurse sorted me out a sample bottle and path lab bag/ticket, but I've not had a very productive infection since then. Apart from one that started on a weekend, so I didn't do a sample as I thought it would be no good.

Originally I was given to understand that there is no point doing a sample if it can't be tested for 2-3 days. I now know that it can be kept in the fridge, sealed container of course, for up to 5 days and still be viable. No more than 2 days at room temperature though.

Most times when I start I wake up not being able to breathe and then have a good coughing fit, where the end product ends up in the loo. I'm not awake enough to remember that I need to get a sample.

With GP's it's often a case of 'try this, see how it goes' and you go back if it isn't working. At least having standby meds gives some peace of mind if you start with something and can't get down to the surgery.

The triage nurse at mine kept telling me off, saying I need to be seen by the doctor. I suggested she come to give me a piggyback as I couldn't make it on my own! The doctor usually asks a couple of questions and issues a prescription, job done. I now have them on my file, so I can just phone and get a prescription issued.

Obviously, if I notice anything different I would let them know. I've left the sample pot in the bathroom now, to try and remind me next time.

Amoxicillin has no effect on me - ever. I tend to keep doxycycline in and that works for me. I had a problem in that I took amox for a week and then always needed another ab, whereas with others I only need the one course.

My specialist tells me to use 14 days of clarithromycin with nothing less I have never produced a test as I have never brought anything up though. Just had the biggest cold ever and have a teen at home with Glandular Fever hoping to stay well, so far all ok

My specialist also told me that with a cold the chest infection can follow 7 days after the cold. I used Amoxicillin for 5 days before when the GP did not know what I had wrong with me, that's standard form GP's as Amoxicillin is a broad spectrum drug but not specific to chest infections. If you can make a test then I think that's a good thing before taking the drugs, but if like me you cant then that's the reason I have clarithromycin for 14 days and no less of a course . Take care x

This is a really interesting thread. I have never had them but it is what they have given me in my rescue pack, so I suppose I will have to wait and see.

Lynne xx

My problem is that my sputum tests, even when done with bronchoscopy, rarely reveal which bugs I have. I have had amoxycillan hundreds of times, clairithromycin, can't take cipro, sometimes have co-amociclav, etc. At the moment on doxy. I have aspergillus too so I'm a bit of an enigma

I agree I have friends who have taken sputum samples to path lab and told they have no infection. Reason I go along with my GP. However, do realise some people on this site are so poorly it is so different. Sometimes think am on borrowed time. I do know laughing breaks mucous as well as good walk! Am I supposed to reply to every answer? Not used to this has ended up with my husband cooking dinner and tell ing me to keeps answers short but only get on to laptop a couple of times a week!! Thanks Katie JJ

Amoxicillin dosn't work if I have a chest infection, usually have 10 days of Co Amoxiclav now.


Check out NHS Choices site regarding Bronchiectasis - scroll down to where it says Antibiotics -

Continue reading for guidance on treatment and preventative measures.

sure hope you can clear the infection soon. If your doc is adamant about not doing a sputum test perhaps you should be thinking about getting a 2nd opinion. With NHS Choices guidance in mind.

Thanks refer to above trust my gp (well maybe not other health issues) tkae care and a healthy 2013 KJJ

I have found that neither Amoxicillin nor Amoxiclav (which is Amoxicillinn plus Clavulanic Acid) have ever had a satisfactory result on my chest infections, even when being prescribed longer and stronger courses. Doxycycline does have good effects and I have been prescribed a small daily dose with an emergency pack doubling that dose and adding in prednisone. On investigation I discovered that Amoxicillin is the cheapest antibiotic available. No doubt just a coincidence, eh!

No you are right other health issues have proved the same the cheaper the better. BLF nurse sorted me out. Post CAT scan saw the specialist did not realise he had siad I could go on generic ? med. Was so poorly for weeks until rang BLF nurse I had been on (exc spelling for nasty people out there moderaters are watching for u. Seretide Salm something £70 a throw) Got back to GP practice nurse altered prescription and felt so different KJJ

This article is in the Southern Echo today !!!

COMMONLY prescribed antibiotics do not help patients get better quicker, research by Southampton scientists has revealed.

A study led by the University of Southampton discovered that the antibiotic amoxicillin is no more effective at relieving symptoms than having no medication at all.

The drug, often used by doctors to treat chest infections such as bronchitis, was shown to make little difference in patients, even among the elderly.

In the study, 2,061 adults with chest infections across Europe were randomly assigned to receive either amoxicillin or a placebo three times a day for seven days.

Results found little difference in severity or duration of symptoms reported between the two groups.

This was true even for older patients aged 60 or more, who were generally healthy, where the drugs appeared to have a very limited effect.

Side effects Although significantly more patients in the placebo group experienced new or worsening symptoms – 19 per cent compared to 16 per cent – just two patients in the placebo group and one in the antibiotic group required hospitalisation.

Patients taking antibiotics reported significantly more side effects including nausea, rash, and diarrhoea, than those given placebo.

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Paul Little, professor of primary care at the University of Southampton, said: “Patients given amoxicillin don’t recover much quicker or have significantly fewer symptoms.

“Indeed, using amoxicillin to treat respiratory infections in patients not suspected of having pneumonia is not likely to help and could be harmful.

“Our results show that most people get better on their own. But, given that a small number of patients will benefit from antibiotics, the challenge remains to identify these individuals.”

I've just cut & pasted the article from the Echo - my husband (IPF) has doxycyline as his standy by antibiotics and they do seem to do the trick.


Over the years I too have had numerous courses of various antibiotics, indeed as a child penicillin was all we had. (b***** hell those injections really did hurt) It all depends on what the bug you are growing at any given time is sensitive to. I always have standby abs, which are invaluable if I get ill during a holiday period or weekend (which is often the case), but if I can I will get a sample down to the surgery. I do my physio and get a sample, fill in my microbiology forms and get it down to the surgery less than 2 hours before the van leaves for the lab. The bugs die very quickly outside the body (if only they did the same inside), and this can cause a false negative result. A sputum sample is useful for 2 reasons 1. If the bug is not sensitive to the ab you are taking, both you and your doc will know what to prescribe which will work. 2. Your consultant or doc will get an idea of the pattern of bugs which like to take up residence in you cosy lungs.

Had heam inf in the main now for a year and that particular bug is now resistant to amox, co-amox, and although it comes back as sensitive to doxy it's going the same way as the amox. Got one more to try which the bug is sensitive to but which on my notes I had a reaction to in 2004 - if they don't work or I can't tolerate may be home IVs.

If I grew another bug it may well be sensitive to amox.

I am just wondering if Prof Little was talking in the main about the 'normally well' who have an infection, as abs are generally overused in the normally well and farm animals far too much. I say that because of the last paragraph "Our results show that most people get better on their own. But, given that a small number of patients will benefit from antibiotics, the challenge remains to identify these individuals."

Personally I trust my consultant's judgement as he is a specialist in cystic fibrosis/bronch.

Katie I would have thought 6 days was far too short a course in bronchiectasis.

Good luck finding a suitable, effective ab for whatever bug you are growing Katie.

Love xxx

You arer joking my favourite GP would only have given me 3 days (standard) reason I used to get 6 was I saw one of the other GPs who had seen me cough cough down their corridors for two year I thin had a spasm of conscience gave me an extra dose. I love it!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!KJJ

I have bronch and am on my 5th lot of amoxicillin since September.

Maxer xx

But how are u ?KJJ

Not good, always SOB never feel well, cant walk far, all the usual we all suffer with.

maxer xx

My husband has bronchiectasis after getting one infection after the other and taking amoxcillin and having it clear up and then come back in weeks

the specialist at the hospital has him permenantly on clairethromycin I know that's not spelt right 1 tablet 250 mg a day and he is so much better hasn't had a chest infection for months now no coughing up gunk he feels so much better

VG x

Did not want to reply to you as my husband is the original "grumpy old man". No, sorry I do sympathiser we do not mention husbands/wivespartners they have a lot to put up with. Not as much as us tho?KJJ

I have bronchiectasis (4 years) to the point now where I'm on the disability pension.

I'm on spiriva 180, and seretide 125 which I take twice a day.

Thankfully i have never had any kind of lung infection. I put it down to the fact

(As I have mentioned before on these posts) that I take a vitamin b12 and a zinc tablet every morning with brekky. Both are excellent for boosting the immune system.

I also walk or ride 3 to 7 Kms every other day.

Remember "The chair is a killer"

I don't just rely on prescription medication.

I thin k you are right whatever helps the immune system KJJ x

I have bronchiectasis and amoxicillin has never done anything to help, tho aeons ago, when I just had asthma+bronchitis, it did sometimes work at 500mg, or in the form of augmentin (ie amox+clavulanic acid)

Of the oral abs, I think ciprofloxacin is best, but I can't take it now as it's caused tendinitis.

So I take nebulised colomycin, oral azithromycin x 3 a week, and if that fails my current rescue ab is doxycycline.

As cofdrop says, the Prof was talking about normally healthy people, not those with lung problems.

I don't take vits or mins but I do follow an extremely healthy diet, and like keith I believe exercise is crucial so I have a good brisk walk every day. I've just bought an exercise dvd for those days when it's too wet.

ff x

Had to give up my beloved yoga when misdiagnosed with late onset asthma for 2 years. Now just walk if the weather is suitable and try to do ygoa exs as if you panic with breathing problems I at least know I can control my breathing. Maybe another thread yoga is fantasstic to control your breathing if you r panicing. Sorry terrible typing KJJ x

Some brilliant answers here from everyone. I have bronchiectasis, lifelong same as cofdrop and I always send a sample to lab when infected. The lab told me to send mucus with as little saliva in it as possible as the saliva spoils the sample and can make it a false negative.

I find amox useless and try to keep my immune system good with strong probiotics which have b12 in also some raw green foods/drinks, I believe infection cannot thrive in a healthy alkaline body and for me this is working together with daily lung clearing using my Lung Flute mucus clearing device.

Like keith49 I do not rely on prescription medication.


I tkake super probiotics which also encourage pre biotics growth after taking anti-bs (Healthspan). Interesting re alkaline I am ab solutly ascidic (excuse spelling very unhealthy will have to change diet. KJJ

Like fairyfootsteps, I have oral azithromycin x 3 a week and also Seretide 500 [2x day] and Spireva Respimat [much easier to inhale]. I also eat a lot of 'live' yoghurt which I think helps too.

I have bronchiectasis and COPD but when I get another infection I just tend to tough it out as other antibiotics don't do much and I don't want to go to hospital!



So agree. Went to another hosp clinic not bronch misdiagnosed again. Will rely on BLF and GP until I get worse! My husband has now cooked dinner because of me replying to everybody (should I?) He is watching Antiques Roadshow and an expert weanted to cut the balls off a bed he is now upset (very very upset) so will sign off. K x

Hi. I have Bronch too, since birth but only diagnosed since age of 9. Over the years I've had the majority of the anti biotics listed by people above. When a paricular one stops working, gp tries another.

At the moment i'm on Azithromycine, 1 daily for at least the whole of winter. Then if I have a flare up, I take 2 aday for 7 days. Amoxicilin is the antibotic that seems to work fine for a coulple of courses, then stop working.

I ususally only see my specialist when i get a persistant cough, even though by the time the referal has been made, appointment made and actual appointment day arrives, couch has usually cleared.

Its intresting to know that there are so many people who have bronch as i was told years ago that it was so rare.

I have a 2 week course of doxy at home for when ever needed so I can take immediately I know I will get a chest infection as it always seems to start on a Friday evening so wouldn't be able to see a doc till the Monday, I seem to get very poorly quickly with out much warning. I always get someone to take a sample to the hospital before I start them, then my doc calls me if I need to change anti b's. I seem to grow same nasty bugs. Tried many types before doxy including amoxicillin which did nothing.

My consultant advised me to keep Amoxycillin 500, 2 weeks supply, at home for when I have an exacerbation. No mention of a sputum sample first.

Hi Poemsgalore (how did you pick that name?). I think you will have gathered Amoxycillin (from above comments) that it does not have much effect on Bronchiectasis. I keep Azithromycin 500 mg 3 days supply at home. I have actually got 6 days supply (had extra in case when on holiday). My GP, I think, would soon have me down at the path lab if these anti-bios did not work. That suits me, as having been under the local hospital forother problems I want to manage my Bronch myself, with GP and BLF helpline for as long as I can. However, everybody is different and you have to do what is right for you. All I can say one friend had a sputum sample come back negative (many reasons can casue this) and GP said, therefore no infection!!!!! I wish I had bought a flutter at the beginning (now on NHS) as my physio is much less exhausting. If I hadn't had yoga exp. I would have gone to BLF Breathe Easy Group which I might still do. There used to be a BLF nurse with knowledge of Bronchiectasis who could probably help you. I think there is a Gold Standard for Bronch which I know I do not get, but as long as I can see my brilliant GP and have BLF helpline I am content at moment. All thebest Katie.

Took amoxi for a lung infection caused by my severe sinusitus.

1st course some effect, had a repeat, near the end little effect *and* I had developed 'Thrush'.

Eventually got Biaxin (Clarithromycin) which I took before; two days much improvement, four days things breaking up nicely. They don't like biaxin as it interacts with statins which I take and have to stop.

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