Hi dear fellow sufferers. I have a question and am a bit embarrassed to ask as feel I should know the answer. I have moderate bronchiectasis but thanks to the Australian weather, always sunny where I live, I only get flareups every 18-24 months. I have a flareup starting now ... we have moved so I saw a new doctor closer to home, who wouldn't prescribe antibiotics. Because of COVID she wasn't interested in taking my sputum sample for pathology. Just did all the COVID testing and sent me home. I normally end up on Doxycyline. I knew it hadn't taken hold yet ... my lungs weren't rattling but have been consistently bringing up greeny coloured sputum each morning & a little less coloured throughout the day for 5 days now. So what is the protocol in the UK if lungs sound clear, but plenty of sputum coming up and it's hard to shift? Do doctors prescribe antibiotics based on pathology from sputum sample only. Coughing a lot as usual also. The doctors in Australia really have no idea about prevention ... I'm afraid if it's not nipped in the bud it will escalate to pneumonia like it did last time. Do our lungs have to be rattling like a train on the tracks before Drs will prescribe antibiotics? Many thanks for your thoughts.
When to prescribe antibiotics - Lung Conditions C...
When to prescribe antibiotics
Hello Cara, 👋😊
Don't be embarrassed. No-one has all the answers. And I am wondering if it's "doctors in Australia" or that doctor in particular.
I can't speak for the U.K. but in Japan you'd be asked for a sample of whatever you bring up to be sent for testing. And yes, antibiotics and steroids would probably be prescribed.
I really don't understand why a sample couldn't be taken. Have all the laboratories shut? Are people supposed to somehow miraculously stay fit and healthy in honour of the pandemic? Is that possible? Does the world stop turning? I give up. 😞😏 I think if you can, please get a second opinion. 🤔
I'm sorry it's not straightforward as it ought to be. At least you are now entering summer and hopefully it will be a good one. Take good care of yourself.
Cas xx 💐☕🍰
Thanks Cas ... the doctor who did the COVID testing was a visiting doctor at a local clinic. This clinic has a good reputation but they've been using visiting doctors for COVID testing who don't give a rat's arse lol!! Thank you for your input though hun ... are you in the UK? If so I bet ur back to home quarantine are you?
Not oral steroids for bronch Cas, unless it is combined with asthma or copd. Thanks for supporting Cara though. She is experiencing the usual bronchiectasis complaicency, brought on by ignorance and a refusal to acknowledge it.xx
These doctors make me want to stick pins in my eyes!
You know your condition well and you know that there is a change and that you need to take a two week course of your appropriate antibiotic in a high enough dose NOW!
And yet, this stupid, ignorant doctor is blocking you from treating your condition which will lead to a worse exacerbation. She is not meeting your needs and is on the verge of doing harm which is contrary to her hypocratic oath.
If you have a consultant ring them and get them to tell your doc what to give you.
If you don’t have one ( get one- a bronch specialist not a general respiratory one) print off the guideline for management of bronch on the British Thoracic Society’s website and stick it under her nose.
Most bronchs here have their principal relationship with their consultant who instructs the GP which antibiotics to prescribe and by which delivery system ( oral, nebulised or IV). We also keep emergency packs of our oral abs at home because they need to be begun at the first sign of an exacerbation. Most GPs here are happy to have the expert’s guidance, because as you have discovered, they have hardly any knowledge of bronchiectasis.
You are lucky, your bronch is mild, you manage it well and you want to stay that way. I’m afraid that you are going to have to be very pro active with your doctor or find a better one before her neglect causes you to have exacerbations which lead to further lung damage.
Good luck
I have had Bronchiectasis for over ten years now, and so far been managing infections with maybe a sputum test, and a weeks supply of amoxicillin. I have just had a rough week of temperature and weakness and no appetite, pain in chest etc. My rescue pack of amoxicillin saved the day. When I tried to order a replacement I’m told no rescue packs are being given. Feel desperate. Not able to get around easily to surgery etc, as 86 years old.
Well one week isn’t enough for bronch anyway and amoxycillin is not the best antibiotic as it is old fashioned and doesn’t deal with the bugs that we tend to get very efficiently. Although at present it seems to be coping for you. Your GP needs educating about managing bronchiectasis. Refusing a rescue pack shows gross ignorance of your needs. COPD patients have rescue packs and they are also recommended for us.
If you have a bronch consultant do ring their secretary and tell them the problem. Ask that the consultant tell the GP what to do.
Did you speak to your GP or only to the receptionist or pharmacist? Maybe a telephone consultation with the GP could get it sorted. I recently had a problem with the pharmacist who didn’t want to give me one of my heart drugs. I spoke to the GP who put her right.
Do you have someone who can support you in this? With going to the surgery or to see a consultant? If you don’t have a bronch specialist to instruct the GP you certainly need one. They are usually at large teaching hospitals.
I appreciate that the current situation makes getting these appointments almost impossible and I’m sorry that I can’t suggest a better way to help you.
Thanks for your reply. I will try to speak to our gp my information was just on line where I put in my request. Finding it all exhausting and as if I am on the rubbish heap, quite honestly. Love Iris x
Oh dear Iris I am so sorry that they treat you like this. It really is a dereliction of their duty towards you. This kind of neglect affects not only our physical well being but also our mental health. I hope that you get somewhere with your GP. If not, a formal complaint in writing to the practice manager and a copy of the bronch guidelines from the British Thoracic website may make them pay attention. When, of course, you can summon up the energy. I do find that my bronch consultant is the best person to deal with these problems. Strangely a, I have had more problem over my heart condition and GPs refusal to prescribe iron tablets. In the end the heart man rang him and hey presto, iron from then on! I still made a formal complaint to teach them that I won’t be fobbed off. Good luck I know that it is awful.
Thank you so much for the advice to print off the guideline for management of bronch on the British Thoracic Society's website Littlepom. That's a great idea! They have a Lung Foundation in Australia now but it's got little to do with advising GPs on management. Seems they are still in the phase of trying to get programmes out there to teach GPs more about diagnosing and management of lung disease. I'm not under a bronch consultant because I couldn't find one ... plenty of general respiratory surgeons though. I haven't gone to one because so far I'm managing it well on my own as I know what I need and when I need it, I have an active lifestyle (when not in an exacerbation), and am growing a few greens/herbs in the garden to assist my immune system. I've never encountered a doctor here in Australia who will allow an emergency pack which makes it difficult to nip exacerbations in the bud but will see a new doctor on Saturday and see if I can't get any joy from him. As always, you have been such a wonderful help with your advice ... you are indeed a rare gem and HealthUnlocked is lucky to have you!! Sending hugs and many thanks for your time Littlepom.
I do hope it helps. Hopefully suggesting to the new doc that emergency packs are standard in UK and that given the covid problem it wd be better for you to keep one at home so that you can start as soon as an exacerbation begins ( stress that u know when this is) rather than having to put yourself at risk going out to get them when you are already vulnerable is a sensible option may work.
The worldwide treatment and management of bronch is shameful and so many of us have to do what you are doing. Self manage on a day to day basis and fight with the medics when we need the medications that they have to authorise.
My practice are very good and keep my rescue abs ciprofloxacillin on repeat. I try to keep two lots in my cupboard just in case.
I do wish you the very best.x
Gd luck on saturday.id write down,in bullet points,what u need to tell dr.brief and to point.we bronchiectasis patients need to nip infective exacerbations in the bud,asap.dnt feel on scrap heap - yr not xx
Im lucky my dr tends to go on my experience and if i say its feeling like an infection they take a sputum sample and give me antibiotics for 2 weeks. I also have emegancy antibiotics and steriods to start straightaway, if i cant get to see a dr. You know your own body, start to become a skweeky wheel and if that dosent work could you change gp?
All my consultants write in their letters to my GP that they are to test my sputum at the sign the first sign of infection and give me a two week course of antibiotics. My current one is co-amiclav. I keep these as my rescue antibiotics and they are in my repeat prescription so no problem getting them yet. I usually take a sample in to surgery armed with a copy of one of these letters to do battle with the guards on reception. Think my GPs are happy to let the consultants take the responsibility which suits me. I wouldn’t normally even speak to a doc. I think you are going to have to be proactive before you feel too poorly to be so. Good luck I hope you feel better soon.
Thank you Mooka. Yet to find a bronch specialist in Queensland, Australia but will keep hunting. Only lots of general respiratory surgeons. Therefore have not been under a specialist even though I've had this since I was 5, and I'm turning 60 this year. I like the idea of rescue meds and have felt the need for them for some time but doctors here not happy to give out advanced prescriptions without a zillion visits first. Thank you for your advice ... I really appreciate the time you have taken to reply hun. xx
Hi Cara4116, I started with problems a couple of weeks ago, shortage of breath, wheezy. I phoned the gp and she prescribed ab and steroids (my surgery wont give rescue meds anymord unless you have severe copd) but the sputum test was normal so she said to stop the ab and just take the steroids, I was only given a week and they have done nothing for me. I spoke with my rheumy nurse yesterday and she said to ask gp for a chest xray as this could show up what was going on in my chest. I am waiting a phone call for this now. I find that it is getting more difficult getting treatment from my gp. Once they have prescribed something , whether it works or not you are then dismissed. I do hope you get sorted and your gp listens to how you are feeling x
Hi Izb1 .. which country are you from? I'm in Australia. I'm so sorry to hear your plight as well ... it irks me that they do oxygen stats etc. and say "you're ok" ... I don't give a damn what their shitty little finger gadget says ... it can't measure what we are actually experiencing. They won't listen and really don't care in the end. Not fit to be called doctors. I'm far from being a hypochondriac, so if I say something's not right, it's not, and I expect them to listen and take me seriously. What colour was your sputum and how long had you been bringing it up for?
Hi Cara, I am in the UK and think they just dont take bronchiectasis seriously enough. Littlepom is right and I should get a specialist in this field to deal with me. The respiratory consultant that i was under has discharged me as he thinks my condition is mild, I must admit it doesnt feel mild to me. I am a bit confused with this latest flare as my mucus hasnt changed colour, which it normally does so am not sure what is going on, but just know i dont feel well and my chest feels so heavy. I have a daily problem with mucus as I have a sinus problem so bring it up all day amd waiting an op for this, due to the coronovirus I am not holding my breath for when this will get done. Lets hope things get sorted for both of us x
I'm so sorry to hear this. Yes COVID times are not good times for bronchs. Makes it even harder to be taken seriously. This is why I've said to my kids I'm happy to "go" at 70 lol :). I'm 60 soon, so not long to go ... it's biblical to have 3 score year and 10 + 70 years of age, ha ha.
Ha! I am 68 and not ready to go just yet. If we could have quality of life we would be happy to bumble along. I always feel better in the summertime as i can get out in the garden and love spending all day pottering, bit early to say but roll on spring. I suppose you are coming into your summer months now, hopefully this will make you feel better x
Hi Cara,
I'm also living in Australia but luckily have a doctor who prescribes antibiotics for me to keep at home in case I need them. You're right - when you need them, you need them as soon as possible. Also by the time I need them, I am too sick to sit in a cold waiting room for an hour waiting for a doctor to prescribe antibiotics and too sick to go to the chemist and get them. The last thing I want to do is go out of the house. Usually you realize how sick you are in the afternoon and then you may have a doctor who can "fit you in" in two days time! Without antibiotics that night, I'm usually much worse by morning and then it takes longer to get better.
Unfortunately doctors in Australia, and probably elsewhere, have been told they are prescribing too many unnecessary antibiotics. Incorrectly prescribed antibiotics also contribute to the promotion of resistant bacteria so now doctors are afraid to prescribe them even when you need them.
You can possibly get your previous doctor to send an email to the clinic detailing what you need.
Also google New Zealand swine flu Vitamin C. This seventeen minute video from the 60 minutes television team in New Zealand is interesting and may help. I have used intravenous Vitamin C and it does work. Find an alternative medicine doctor in your area.
Hi Tugun .. great tips ... do you live in Tugun because I'm on the Gold Coast at Helensvale, originally from Currumbin Waters. I will certainly look up the NZ swine flu + Vit C though ... glad to hear it's working for you because I'm all into alternative methods to avoid drugs as a last resort only. Thank you for your help!!
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