Q: I am a patient of steroid dependant asthma with hypertension. I am having temperature of 100 degrees F for the last 3 weeks. On investigation, WBC count was 16,000 & urine culture showed E. coli infection sensitive to Amikacin & Levofloaxacin. Before urine culture, I took Tab Augmentin Duo for 5 days followed by Cap Sparfloxacin for 5 days. I have now taken Inj Amikacin 750mg and Tavanic 500mg for 5 days. I was taking Tab prednisolone 5+2.5mg for 7 days & then Prednisolone 5mg till date. Last week, Serum Cortisol at 08:00 am was 4 & WBC count was 10,000 & temp 99 degrees F. I am also suffering severe constipation, dryness of skin & my present BP is 120/70. I would like to know if Tab Prednisolone should be increased in this state & if so in what dose?

A:It depends on how much prednisolone you have taken in the recent past and for how long. Off hand, I would suggest, stay with the 5+2.5 mg dose till the infection comes under control. You may need to increase the dose for a short time if the infection worsens. All this should be done by your treating physician. Moreover, given your constipation and dry skin, I would also suggest that you get your blood T4 and TSH tested to rule out hypothyroidism, and that you make sure you are getting plenty of water to drink and laxative fruits to eat (eg papaya, litchi, chiku).