Common antibiotics for BE exacerbation.

Antibiotics are ordered based on sputum cultures or CXR confirming pneumonia or MAC. I took Ceftan for 10 days and when chest CT picked up another area, i was admitted for 5 days of Zosyn IV.

Leaving a sputum sample first is best before starting antibiotics. Even after culturing first, often my cultures show normal flora even though I feel miserable -- headache, aches, malaise, increased cough/mucus and darker looking sputum. I used to be able to alternate between augmentin and bactrim but I developed some bumps on my legs with bactrim. I had an allergy workup for bactrim and it showed while in the allergist's office I was not allergic. Later that night I developed some red bumps on legs. Frustrating. With the pulmonologist I plan to discuss re-trying bactrim again with an antihistamine. It would be good to have in the arsenal.

When my chest sounds really bad and I don't fully recover from an exacerbation after augmentin (or there's bronchitis or pneumonia) I'll be prescribed levaquin. So far that's happened not more than every other year. It's saved for serious infections.

I have started to wonder about 3x week azithromycin to curb the exacerbations and decrease mucus. I am well aware that the facebook support group cautions against it. There are studies to show, however, that it helps reduce inflammation and exacerbations in NCFB bronchiectasis without MAC/NTM. Many people here have used it with success. So far I have not be diagnosed with MAC/NTM (working hard to keep it that way). Hope this is helpful. I know I gave you an earful!

That quite all right Scoop!!! I’ve read many, many of your replies and you are an experienced knowledgeable, patient. Any and all information you want to give me I’ll gladly accept.

In order to give the correct antibiotic, it is very important to have sputum cultured first if there is an exacerbation.

I had a very serious exacerbation about 4 years ago but nothing could be identified from my sputum. My pulmo felt based on the look of the sputum that Augmentin would be a good option. He was right. But I had to take it for 4 weeks. One and a half years later I was feeling enough exacerbation to be prescribed Augmentin again. Took it for 2 weeks but it did not help that time. That is when I suggested to my pulmo that perhaps I had Pseudomonas (which does not respond to Augmentin). Turns out I was right. I never realized that the sputum test for Pseudomonas was a specific test. And I wish my pulmo had ordered that test sooner.

Hi irene8. What is the specific test for pseudomonas. When my previous respiratory test did not show anything and I had bad flare up I was given levaquin which helped. So I wonder what test it was. The last two weeks I fight parainfluenza4 infection which came with terrible cough and increased sputum( chest X-ray showed no changes) with 16 days of prednisone. My pulmo said it was not bacterial based exacerbation so steroids are the solution. I have last four days x1 10 mg tablet but I still cough. Has anybody taken prednisone and when did you see improvement

I didn't realise that was a specific test for pseudomonas either. Thank you.

It is called a CF Respiratory Culture.

At least that is the test that the lab uses at the U of IA hospitals and clinics in the pulmonary specialty area. Maybe it is different depending on the lab??

@cwal and what do you do if the culture is negative but you still has symptoms of an exacerbation? Do you chalk it up to colonization?