Respiratory - Nebulised Amoxicillin antibiotic therapy

Why do I need nebulised Amoxicillin?

Amoxicillin is an antibiotic that we can make into a mist (nebulise) so that you can breathe it straight into the lungs. We have suggested this therapy because you are sensitive to oral antibiotics (tablets/capsules/syrup) or they are not helpful and you are having lots of chest infections.

A small dose of nebulised antibiotic (mist) taken twice daily can help to fight the bugs in your lungs and reduce the number of infections you have. Taken in this way it has proved to reduce some of the side effects seen with oral antibiotics (tablets/ capsules/syrup).

How do I take the medicine?

1. Collect all the equipment needed to take your nebulised Amoxicillin antibiotic.

List of equipment and medicine needed

On prescription from your GP

• Amoxicillin dry powder drug vial (tiny glass bottle with dry powder antibiotic inside)
• 5ml sterile water for dilution
• Needle with syringe
• Sharp’s box
• Salbutamol 2.5/2.5mL nebule (pre-dosing before antibiotic)

Provided by your hospital specialist

• Air compressor
• Replacement filters for the air compressor
• Nebuliser mask or mouthpiece with filter and tubing and replacement disposable filter pads

1. Wash your hands thoroughly and dry.
2. Mix up your medicine as demonstrated in clinic.
3. Draw up 5ml of sterile water into the syringe using the attached needle (as demonstrated in clinic).
4. Put the liquid into the Amoxicillin powder by putting the needle into the glass vial (small bottle with medicine in) and pushing down the flat end of the syringe (plunger).
5. Roll the tiny glass bottle with the medicine in between your hands until it starts to dissolve (do not shake or spin as it will cause frothing which will make the medication more difficult to draw up back into the syringe).
6. Leave it to one side whilst it completely melts into the solution.
7. Use the nebuliser unit to take one full dose of Salbutamol as demonstrated in clinic. This will relax the breathing tubes and lessen the risk of a reaction to the nebulised antibiotic.
8. Wait 10 minutes after the Salbutamol nebuliser before setting up your antibiotic nebuliser.
9. Set up the filter unit plus nebuliser with air compressor.
10. Take the antibiotic mixed solution out of the glass bottle by putting the needle into the top of the bottle. Turn the bottle upside down and ensure the needle stays in the liquid and not the empty gap. Pull back on the plunger to get the medicine into the syringe.
11. Squirt the mixed medicine solution from the syringe into the nebuliser pot.
12. Place the syringe with attached needle into the sharps box (Do not put the plastic cover back on the needle, as you may prick yourself).
13. Put the nebuliser unit mouthpiece in your mouth/mask over your mouth and turn on the air compressor.
14. No need to breathe deep or fast as you will have the best results if you breathe at your usual rate and rhythm.
15. The nebulisation of the drug will take up to 15 minutes.
16. When the nebuliser machine starts to make a different sound, spluttering and spitting, it has finished.
17. Turn off the air compressor.
18. Leave the room well ventilated for 1 hour.
19. Wash your nebuliser units and leave to air dry as directed in the instruction provided separately and demonstrated in clinic. Change filter pads daily.
20. Repeat the process morning and evening, every day.

Cleaning and maintaining your nebuliser kit

• Your nebuliser kit and consumables should be cleaned as per manufacturers instructions
• Filter pads should be replaced after each dose or daily as a minimum
• Consumables such as mask, tubing, filter valve and air filter should be replaced annually
• Please contact the Respiratory Nurse on 0161 206 3161 to arrange replacement of this equipment
• Date replacement equipment is needed is:

Alert

You may experience a delayed reaction to the drug within 12hrs. If you become extremely ‘wheezy’ or ‘breathless’ you must go to the Emergency Department immediately or seek medical review with your G.P. or Out of Hours Service.

Safety advice

It is recommended that nobody else be in the room whilst you take your medicine where possible. The room must be well ventilated (open window). It is suggested that the room is not used for about one hour after each dose has finished.

Please note

Conclusions drawn from the data are that a one-off drug challenges and ad hoc exposure by carers and family does not pose a threat to the individual or to a foetus in pregnancy.

Your condition will be monitored from time to time in the chest clinic, under the care of your specialist. Please make sure you go to for your next visit.

For further advice telephone:

Nebuliser service - 0161 206 4423/0161 206 3161
Dr Needham’s secretary - 0161 206 5155

We do not have an email advice line, but you can email Dr Needham’s secretary, Jane Browne and she will direct your enquiry to the most appropriate person: jane.browne@nca.nhs.uk