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Prednisone for flare-up - Bronchiectasis with asthma
Hi. I have mild Bronchiectasis (diagnosed last year) and moderate but usually well-controlled asthma. The 2 times I have had the start of an exacerbation (low-grade fever, tight chest/reduced stamina, more mucus production, and this time some Hemoptysis for the first time) my local pulmonologist has prescribed 5 days of amox/clav and 5 days of 40mg of prednisone. I would love to avoid taking prednisone each time something is starting up but I wonder if it's necessary with the complication of asthma.
Also, for Hemoptysis (maybe 1/4tsp), I am worried about doing saline and huff coughing/aerobika, etc. in case it makes it worse. But I know that increased airway clearance is important during exacerbations/infections. How do others manage this balance? Thanks!
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I hate prednisone, especially with other steroids I have to take. It makes me anxious and deprives me of sleep. 2 or 3 times a year I have to do it though. Working with my pulmonologist we settled on 20 mg/ day for ten, or if needed, 20 days, and that has worked for several years.
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2 Reactions@simonian Prednisone is Round!. If worse after 48 hours OR no improvement in 4 days, we go to antibiotics. Usually the prednisone does it. But "that was then" - since getting my asthma well-controlled, and figuring out some of my chest tightness was heart-related, I have only had one exacerbation in nearly 2 years, and it came after my first Covid infection in 2024.
Last week I saw my pulmonologist and we reconfirmed the infection protocol. I'm hoping not to need it.
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3 ReactionsThanks for that information. I have started on prednisone 2nd day, and am hoping i dont need antbiotics at all. I am glad you are doing well.
I found taking Prednisone 40mg daily for over a year made my hair fall.out, so I mentioned this to the Dr. After a week in hospital on 3 antibiotics, the Dr gave me 250mg Azithromysine 3 times a week and a Budeflam inhaler when needed as maintenance meds and I haven't had a flare up for two winters in Cape Town, .So now I only take the meds during winter and it keeps the lung inflammation at bay.....