Hi, I have thoroughly read your question. I am sorry to know that your sister is not feeling well. And thanks for providing such a detailed history about your sister's condition.
After going through the history and signs and symptoms, it seems that your sister needs more investigations to find out the cause/s of her breathlessness and
cough with sputum. A chest X-ray is an important investigation in majority of patients with lung problem as it can give very valuable information about the lungs and other structures in the chest. If she was my patient, I would certainly ordered a chest film for her. She may also need lung function tests to look for any obstructive diseases such as
Asthma or
COPD.
Alongside other investigations, It is also recommended that her sputum be examined for any bug or other types of cells. This would guide any further management. The signs and symptoms like, loss of appetite,
weight loss, breathing with difficulty and green/yellow mucus are all concerning for me. She needs more active and timely management of her condition. Z Pac alone many not be sufficient to treat all types of chest infections.
You mentioned that she has cut down on
smoking which is really a good sign however, I would recommend that she abstain from smoking in view of her condition. There is a lot of help available for those who want to quit smoking.
Hope this helps. And please feel free to ask for any further clarification.