Appropriate antibiotic treatment for chest infections is determined by the bacteria you grow in your airways –detected through sputum analysis. This is why regular sputum samples are essential to guide your treatment.
As part of your self management plan you will be given a recommended antibiotic based on your previous samples. This is the antibiotics you should take when you have a chest infection.
Oral Antibiotics (pills)
For most people appropriate oral antibiotics will be sufficient to treat infections. Early treatment is important in limiting the extent of the infection and in reducing any further damage caused to the airways. It is important always to take the full course of antibiotics and not just stop when you feel better.
Quite often the treatment plan will specify that a home stock of appropriate antibiotics (sometimes called a standby or rescue antibiotics) is made available so that these can be taken quickly once an infection starts. But it is still important to hand in a sputum sample – before the first antibiotics are taken if possible – to test that the bacteria expected are in fact those causing the infection. You do not need to wait for the results of your sputum sample to start antibiotics.
What do I do if I don’t feel better?
It can often take a few days for you start to feel better but if you don’t improve or you get worse it is important that you go and see your GP again to check that you are on the right treatment.
Do I always need to change antibiotics if my sputum grows a different bacteria?
No
We always recommend antibiotics for chest infections but some chest infections will be due to other organisms e.g. viruses or pollutants in the air which the antibiotics will not treat and usually get better on their own. Additionally, sometimes you may grow bacteria in your sputum but it is not the cause of your chest infection. For this reason, if you are feeling better you do not need to change antibiotics even if your sputum sample grows a different bacteria to usual.
Long Term Antibiotics (also called prophylactic antibiotics)
Some people with more severe bronchiectasis may need a longer term antibiotic (taken for a few months or longer) to control their disease. Certain antibiotics, e.g, azithromycin, are taken on specific day (usually Monday, Wednesday, Friday) while others need to be taken daily or several times a day (eg doxycycline, amoxicillin or co-amoxiclav)
There are some risks associated with taking antibiotics long term, including side effects, effects on your gut and the development of antibiotic resistance. It is important that long-term antibiotics are only prescribed when necessary and are reviewed regularly to assess if they are still needed. Even when antibiotics are required for a prolonged period of time you may be asked to stop them for a ‘holiday period’ usually over the summer months when the risk of infection is lower. Your doctor or nurse will discuss this with you in the clinic.
