Upping predisolone with pneumonia

[Chia123]

I came back from abroad on the 30th of Dec feeling really ill. Went to drop in centre and have pneumonia. Given a 3 day course of antibiotics and told to up predisolone to 40mg for four days and then go back to normal dose-7mg. I wasn’t happy about this and my dr said no need. The antibiotics finish tonight and feeling somewhat better but not great. Should I have upped steroids. I don’t contribute often to the site but read often as a great source of information. Thanks for any advice.

[DorsetLady PMRGCAuk volunteer]

Attached is sick days rules post - which advises (in conjunction with GP) how to increase Pred, so it probably would have been wise to increase steroids, but certainly not as high as 40mg -

healthunlocked.com/pmrgcauk....

Might be worth discussing with GP after BH.

[PMRpro Ambassador]

It is used a great deal by specialists in lung conditions to reduce the inflammation and swelling in the lung tissue. The burst of pred was perfectly reasonable and quite safe. My daughter is almost always told to take 40mg when used like that and often for longer. It isn't anything to do with adrenal function.

cochrane.org/CD007720/ARI_t...

[Chia123 in reply to PMRpro]

Thank you for your reply. I am going to take either 15 or 20 mg tomorrow for 4 days as should help while I am getting over it.

[Blearyeyed in reply to Chia123]

Try upping to 20 for a couple of days and then going down in 2.5 mg until you get down to 7.5 , just slightly higher than your current dose , this should take 7 days in total and booth help with the remains of the inflammation from the pneumonia and reduce the possibility of a flare or any side effects from increasing then decreasing your dose.

Drink a lot ,as hydration helps to cool the lungs and remove the residual toxins from your infection.

If you don't take a vitamin supplement start now and take it mid way through a big meal to get the most absorption you can.

Have a vitamin C rich drink like orange juice with your meals as the extra vitamin C will help with your recovery .

Eat light simple meals for a few weeks and give your body time to recover , even if you feel a big uplift in energy don't be tempted to suddenly start doing to too much exercise or start cleaning the house , instead use your energy well in your recovery , relax , do deep breathing through the day and gentle exercise when you are up to it.

Many people find a reduction of dairy or going dairy free for a short time is helpful after a lung infection as it dies reduce the amount of mucus production in the airways and the amount of coughing required to clear it.

Keep your distance from people for a while even if you need to cancel something as your immunity will be low at the moment and you don't want to pick up anything else.

If you find your symptoms returning after your antibiotics finish despite the increase in steroids contact your GP immediately as you may need a further course of antibiotic as some people do .

If that is the case stay on a larger dose of steroids while taking the new antibiotic course ( possibly not 20 mg but 15/12.5 mg ) that will help speed up your infection and reduce the chance of a flare.

Hope you feel better soon , Bee

[Chia123 in reply to Blearyeyed]

Thank you. That sounds like a plan.

[SheffieldJane]

So sorry Chia123. You must have felt so ill. I would have assumed that short term steroid use was indicated in Pneumonia and just done as I was told. I hope you recover soon. Take it really easy. That kind of treatment isn’t to do with treating our GCA/PMR and shouldn’t impact on the tapering, which you will have paused. Amazing drug Prednisalone- treated with respect of course.

[Chia123 in reply to SheffieldJane]

Thank you. I will take either 15mg or 20mg tomorrow as should help even if a little late.

[MrsNails]

It’s pretty standard with a Chest Infections or Pneumonia to prescribe 30mg a day for 5days with Antibiotics and then to return to your Normal Dose.

[Chia123 in reply to MrsNails]

Have finished course of antibiotics this evening. Do you think it is still worth upping steroids to 20mg. Still have cough or just go for the 40g. Thank you for replying.

[HeronNS in reply to Chia123]

I wonder if it's a bit like taking enough pred to deal with PMR flares? Too little gives you the drawbacks and not the benefits.

[MrsNails in reply to Chia123]

I would really prefer if you had the advice from a Medic - we are not qualified to advise really. You could try 111 for advice.

My Son who’s an old asthmatic (as a child) had two courses of 30mg Pred x 5days with two different antibiotics as did his Mother in Law who who doesn’t have any history of chest issues.

Best Wishes

MrsN

[Chia123 in reply to MrsNails]

The dr said I could increase to as much as 20mg if needed last Saturday. I have made improvement without the 40mg so following sick days rules seems to be a good idea and with permission of dr. Next time I am told what to do to get better by an expert in a hospital, I will do it. Thanks for everybody’s replies. Really appreciated.