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Suggest Medication For Dry Cough For A Hypertensive Person
Question: My 65 year old husband, weighing 210 pounds and 5'8" tall, otherwise in good health. He takes Atenolol and Tamsulosin daily. We are on a cruise ship and won't be back to states for several days. I have brought with us the following antibiotics but don't know which one to give him. I have Amoxicillin 500 mg, Ciprofloxacin 500 mg, Zpack, and Septra DS 800-160. Which of these should I give him and how often? He has a dry cough and very tight chest. Thank you!
Brief Answer:
Questions so that I can advise:
Detailed Answer:
Hello and welcome,
He may not need any of these if he has no underlying health problems other than high blood pressure and enlarged prostate, if it is a viral infection. Taking an antibiotic for a viral infection will not help much and can cause problems such as diarrhea.
Can you please tell me more about his current illness:
1. How many days has he had the cough?
2. Is he coughing up discolored sputum, and if so, is it all day or is it after he gets up from lying down?
3. Does he have any nasal or sinus symptoms or drainage in the back of the throat?
4. Does he have a fever or chills?
5. So to confirm, he has no history of asthma, diabetes, immune deficiency such as from chemotherapy, autoimmune disorders, and is not a smoker?
6. When you say he has a tight chest, does he have ongoing shortness of breath?
7. Does the ship have a medical office on it?
8. What is the reason he was given 4 antibiotics? Were you high risk infectious areas (such as high risk for malaria or gastrointestinal diseases) for a prolonged time?
Questions so that I can advise:
Detailed Answer:
Hello and welcome,
He may not need any of these if he has no underlying health problems other than high blood pressure and enlarged prostate, if it is a viral infection. Taking an antibiotic for a viral infection will not help much and can cause problems such as diarrhea.
Can you please tell me more about his current illness:
1. How many days has he had the cough?
2. Is he coughing up discolored sputum, and if so, is it all day or is it after he gets up from lying down?
3. Does he have any nasal or sinus symptoms or drainage in the back of the throat?
4. Does he have a fever or chills?
5. So to confirm, he has no history of asthma, diabetes, immune deficiency such as from chemotherapy, autoimmune disorders, and is not a smoker?
6. When you say he has a tight chest, does he have ongoing shortness of breath?
7. Does the ship have a medical office on it?
8. What is the reason he was given 4 antibiotics? Were you high risk infectious areas (such as high risk for malaria or gastrointestinal diseases) for a prolonged time?
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
As I said, cough just started yesterday. Also as I said it's a DRY cough ...meaning he's coughing up nothing. Just a very tight chest and a deep-down cough. No nasal, no sinus symptoms, no drainage. A little low grade fever yesterday he thought but as I said we're on a cruise ship. He does not have recurring anything, much less shortness of breath.
We will not use the ship's doctor. As I also thought I said, we travel VERY OFTEN to MANY MANY places from Europe to South XXXXXXX to Mexico, the Caribbean islands etc., and therefore I keep 3-4 different antibiotics with us at all times as a recommendation of our usual GP who I cannot contact from the ship. Also I failed to answer your question #5 is no, he has never had any of the mentioned. And is not a smoker either. This answer was not provided in my first response to you above. So please review my previous answer to your questions. Between this response and my last one to you I've answered all your questions.
We will not use the ship's doctor. As I also thought I said, we travel VERY OFTEN to MANY MANY places from Europe to South XXXXXXX to Mexico, the Caribbean islands etc., and therefore I keep 3-4 different antibiotics with us at all times as a recommendation of our usual GP who I cannot contact from the ship. Also I failed to answer your question #5 is no, he has never had any of the mentioned. And is not a smoker either. This answer was not provided in my first response to you above. So please review my previous answer to your questions. Between this response and my last one to you I've answered all your questions.
Brief Answer:
Information
Detailed Answer:
Thanks for answering all of the questions as it provides a better picture.
As he is otherwise doing well and is not continuing to run a fever, and has no underlying illnesses such as COPD, asthma, or a compromised immune system that would put him at more risk for a bacterial infection (which is what antibiotics are for), it would be inappropriate for him to start an antibiotic now.
As the infection just started yesterday, it would not be warranted to use an antibiotic. In the past, physicians used to prescribe antibiotics for bronchitis rather immediately, for example. Now we know that these are usually caused by viruses, and the risks for taking an antibiotic before bronchitis has gone on for over a week, are greater than the benefits one might get from using the antibiotic. Exceptions to this are for people who have respiratory risks such as from asthma or COPD, and immune impairments such as from diabetes.
So, I would not recommend any of the antibiotics for any of the symptoms he is having given the duration he has had the symptoms.
If, however, his fever continues or increases, he begins to cough up purulent sputum, or his breathing deteriorates then I can advise for him to take one of the antibiotics. Otherwise it would be irresponsible of me to do so.
If he has some access to guaifenesin, which is a mucolytic, this might help break up whatever is causing the cough, providing he drinks a lot of water in addition to it. Rest is very important for beating a viral infection without complications too.
Information
Detailed Answer:
Thanks for answering all of the questions as it provides a better picture.
As he is otherwise doing well and is not continuing to run a fever, and has no underlying illnesses such as COPD, asthma, or a compromised immune system that would put him at more risk for a bacterial infection (which is what antibiotics are for), it would be inappropriate for him to start an antibiotic now.
As the infection just started yesterday, it would not be warranted to use an antibiotic. In the past, physicians used to prescribe antibiotics for bronchitis rather immediately, for example. Now we know that these are usually caused by viruses, and the risks for taking an antibiotic before bronchitis has gone on for over a week, are greater than the benefits one might get from using the antibiotic. Exceptions to this are for people who have respiratory risks such as from asthma or COPD, and immune impairments such as from diabetes.
So, I would not recommend any of the antibiotics for any of the symptoms he is having given the duration he has had the symptoms.
If, however, his fever continues or increases, he begins to cough up purulent sputum, or his breathing deteriorates then I can advise for him to take one of the antibiotics. Otherwise it would be irresponsible of me to do so.
If he has some access to guaifenesin, which is a mucolytic, this might help break up whatever is causing the cough, providing he drinks a lot of water in addition to it. Rest is very important for beating a viral infection without complications too.
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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