Experts: yellow pus sputum can take antibiotics

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On December 25, Zhong Ming, director of the Department of Critical Care Medicine at Zhongshan Hospital of Fudan University, was a guest at the Shanghai Science and Technology Forum and answered questions about the public’s concern about the prevention of the new crown.

Q: Recently, I’ve been positive, coughing with very much phlegm, even with blood, and also with many symptoms of yellow phlegm, which drugs do I need to use?

Zhong Ming: Fever and cough are actually very common after infection. Even coughing some phlegm, if this phlegm is white and foamy, this kind is normal. Because of the inflammation in your upper respiratory tract, you will be congested, and when you cough, the violent airflow will damage the mucosa and cause bleeding. The congested mucosa itself is easily damaged, and it is normal to have bloody sputum and blood.

If there are no special circumstances, you don’t really need to take any special medicine, and there is no special medicine. Of course, if the cough is particularly severe and affects your life and sleep, you can use some cough suppressants to treat the symptoms appropriately. This is only symptomatic treatment.

But if yellow sputum or yellow pus sputum appears, it may not be quite the same. In a normal viral infection we are talking about, the sputum will not be yellow and thick, it should be a white mucus. If it is yellow pus sputum, it means that a bacterial infection may be triggered. Because when a viral infection occurs, it can cause damage to your mucous membrane and may affect the immune barrier function of the person’s original mucous membrane, which makes the probability of bacterial infection increase because the upper respiratory tract may be exposed to bacteria. So when yellow pus sputum is present, it proves that secondary bacterial infection has indeed occurred.

Zhong Ming, director of the Department of Critical Care Medicine, Zhongshan Hospital, Fudan University

If there is really yellow pus sputum, it is recommended to go for a little antibiotic. If you are not allergic to penicillin, you can use some amoxicillin; if you are allergic to penicillin, you can use some cephalosporin.

Q: What are the special concerns for the elderly with hypertension and underlying diseases in the family if they are infected?

Zhong Ming: If there are elderly people in the family, especially those with hypertension, the first thing to look at is whether the patient’s hypertension is normally well controlled. If the blood pressure is normally controlled and stable, it is actually the same as the general elderly, and we monitor the general elderly according to the requirements of monitoring, such as chest tightness and shortness of breath, which are indicators of a tendency to cause serious illness. If possible, you can also use an oximeter.

When you have a fever after a viral infection, your body will mobilize, including your cardiovascular system, so your heart rate will be fast and your blood pressure will be high after a fever. At this time, it is important to see if the blood pressure is well controlled during this time. If it is not well controlled, you may have to make adjustments in medication; if it is very poorly controlled, then you may need to go to the hospital and get your blood pressure under control under the guidance of a doctor. This is because at this time, the incidence of complications associated with high blood pressure fluctuations may increase, such as cerebral hemorrhage and so on.

In short, if during this period of time, in addition to worsening upper respiratory symptoms, blood pressure is also poorly controlled and fluctuates greatly, it is necessary to see a specialist.

Q: Is it necessary to take “special medicine”?

Zhong Ming: As we all know, we now have some drugs called “new coronary special drugs”, mainly small molecules of antiviral drugs. It is only a drug that can inhibit the replication of the new coronavirus, after eating it, the viral load may be lower, the virus is more easily cleared by our body.

New Coronavirus drugs

But what does all the medical evidence tell us about the kind of people who need these drugs? It’s these people who have a real tendency to become seriously ill, to use them early. In other words, if you are in good health, you will recover in 7 to 10 days and do not need to take this drug at all. It is really those people who will become at high risk of becoming seriously ill, and these people need to take this drug at an early stage.

Q: Do I need to go to the hospital after a positive? What conditions require a hospital visit?

Zhong Ming: Now the virulence of Omicron is very weak, most people have mild symptoms, that is, only fever and upper respiratory tract symptoms. For example, if you have a sore throat, people will say “pharyngeal blade”, even if you feel very painful, it is still an upper respiratory tract symptom, not a heavy manifestation. For low-risk people, not those of advanced age or those with underlying diseases, it is fine to stay at home. Symptomatic treatment during home stay, a very high temperature with some antipyretic medicine is sufficient, and in most cases there is no need to go to the hospital.

If there are high-risk symptoms, such as difficulty in breathing, shortness of breath, chest tightness, blurred consciousness, or if the elderly are found to be apathetic, unresponsive and sporadic, or if the fever continues to be high, these are signs of danger, and this is the time to go to the hospital.

Also, by monitoring blood oxygen, a significant drop in blood oxygen is a sign if there is a significant drop. In addition, if the mind becomes indifferent, such as a person who is not normally silent, becomes silent, this is a cause for alarm. Also people who usually have underlying diseases should be familiar with the symptoms of their underlying diseases and should go to the hospital if their original underlying diseases have worsened and are not well controlled.

Q: Do pregnant women need to take medicine for fever and what are the things to pay attention to?

Zhong Ming: The principles for pregnant women are the same as those for others, except that the difference for pregnant women is that different drugs have different toxicity to the mother, so when choosing a drug, it depends on the toxicity of that drug to the fetus. There is a classification of drugs. If you want to take antipyretic and analgesic drugs, either use them under the professional guidance of an obstetrician or look carefully at the level of classification of drugs for use in pregnant women when you use them. All drugs, whether they are toxic to the fetus or not, are usually very clearly classified.

Q: Some people will travel recently, how should I protect myself by airplane?

Zhong Ming: It is recommended to wear N95 masks on airplanes because only N95 masks are aerosol-proof. Usually there are no aerosols in a normal environment (except for some confined spaces), but in a small, confined space like an airplane, if there is a positive patient, the probability of aerosol production is still high. Under the current pandemic background trend, the probability of having a positive infected person among passengers is high. If you need to fly at this time and do not want to be infected, it is recommended to wear an N95 mask because medical surgical masks are droplet-proof, not aerosol-proof.

Q: People are often encouraged to drink more hot water when they are sick, how much hot water should they drink specifically?

Zhong Ming: Why do you need to drink water when you have a new crown? It’s really just because when we have a fever, we have to dissipate heat in order to maintain a normal body temperature. And in the fever, the main way we dissipate heat is through evaporation, the higher the body temperature needs to evaporate more water. At this time, the person’s unobtrusive water loss will be more, it is necessary to go to replenish this part of the lost water, so to go to drink more water.

But to drink water should also be the right amount. For example, our normal person’s unobtrusive water loss is 800 ml a day, within a reasonable range of hydration is enough. There is a simple principle, if you have dehydration, on the one hand, you may have thirst, second urine will be less, urine volume will become less and yellow. These can be monitored, as long as you drink water until the urine volume is almost enough with the usual, and then drink more water is actually not beneficial. Some people say drink more water to detoxify the body, the virus may not be eliminated in this way, the virus is mainly cleared by our immune system. Therefore, it is not necessary to drink so much water, it is more important to drink the right amount of water.

Q: Can oximetry react to the tendency of severe illness earlier?

Oximetry

Zhong Ming: The monitoring of blood oxygen can reflect the tendency more objectively. Now buy a fingertip oximeter is not expensive, normal people breathing air, should be above 96-97, below 95, the reading is accurate premise, prove that you have lung problems, then the oximeter can promptly remind you, may need to go to the hospital for consultation. In addition, some elderly people are less functional and less responsive, and can suffer from silent hypoxia, which is a different concept. When the elderly do not respond well, they have the tendency to become seriously ill, unlike the young who have vigorous functions and will respond well. These oximeters can also monitor this.

Q: Does it matter if your heart beats quickly when you have a fever?

Zhong Ming: A normal person’s body temperature rises by 1℃, and his heart beats 12 times faster. It is normal to have a fast heartbeat when you have a fever, so there is no need to be nervous. As long as you do not have a serious heart disease such as coronary heart disease, a fast heartbeat is normal – it means that the body is fighting with the virus. The general population in good health has no problem monitoring at home, and there is no special treatment when you go to the hospital, except for the increased risk of infection.

Q: Who is prone to convert to serious illness?

Zhong Ming: First, the elderly, especially the disabled and demented; second, people with diabetes, severe hypertension, chronic respiratory diseases; third, patients with advanced tumors, especially those who need regular radiotherapy.

Q: Will there be secondary infections after infection?

Zhong Ming: The answer is that it is possible. It is possible to get infected if you encounter a different strain or if the antibody level of the previous infection drops, but there is a time cycle for this process. According to the literature, the world record for the shortest person is 20 days, but that’s the world record and most people are safe for three months with the same strain or a similar strain. We’ve done a little bit of simple antibody research before, and generally within 3-6 months levels are still okay, and after you’ve been vaccinated and you’ve had another infection, the antibody maintenance time and concentration is better, and that’s why we go for the vaccine, because it helps in every dimension.

Q: I just got my fourth booster vaccination, what are some of the issues I need to be aware of now that I have to take care of the Yang members of my family?

Zhong Ming: I have just received my fourth vaccination and I am still negative, so I still need to do my protection at this time. Because it takes time for the antibodies to reach high concentration after the vaccination, it is not a complete protection at this time.

Q: The new coronavirus likes cold but not heat, is it possible to hide some virus in the refrigerator? How should I disinfect it?

Zhong Ming: Viruses stay longer in cold environments, especially in wet and cold environments, such as freezers. If the food you put in the refrigerator is contaminated with a virus, it may indeed survive in the refrigerator for a long time, not just two or three days, but may be contagious for a very long time. If you buy food, it is recommended to do some simple disinfection treatment before putting it in the refrigerator, such as using alcohol spray to treat the surface, so it may be a little safer.