Common antibiotics for BE exacerbation.

My understanding is that screening for Pseudomonas aeruginosa is with the standard sputum culture. Now that you raise this as a potential issue I will double check with pulmonary and report back!

My standard sputum culture tests for:
Legionella
Fungus
Respiratory including gram stain (this is where I thought pseudo would show up)
AFB stain
another one after the stain for NTM (EPIC hard to read, don't like!)

I didn't either. Here's what Mayo states;
This culture is specifically designed and utilizes conventional and additional selective media (compared to non-CF respiratory cultures) to isolate bacteria commonly associated with pulmonary disease in patients with CF.

CF=cystic fibrosis

Looked up this info. Here is what Mayo states about a CF culture;

This culture is specifically designed and utilizes conventional and additional selective media (compared to non-CF respiratory cultures) to isolate bacteria commonly associated with pulmonary disease in patients with CF.

At U of IA it seems to be a distinct test. Maybe it just depends on the lab and the kind of tests they do??

There seem to be events that are called BE exacerbations which can be caused by other things than pseudomonas etc and these events can need treatment with antibiotics. Not all bacteria is picked up in a sputum test. I think sometimes the issues get confused.

Pulmonary confirmed for me that my sputum cultures are screened for pseudomonas. Maybe your lab does something different as standard? Then again, U of IA sounds like a large university teaching facility and maybe they are on to something? I plan to pursue with my care team to double check. Thanks for mentioning it!

As Liz said an exacerbation can be caused by many things but just wanted to mention my experience of taking one of the standard broad spectrum antibiotics usually prescribed (Augmentin) and the fact that it did not work and what that might mean. I think everyone should make sure they have been screened for Pseudo since catching it early is so crucial and since developing it in the chronic form is so terribly impactful to ones health. And in my case a special test had to be ordered which I was not aware of. I had assumed I was screened for "everything" with the usual sputum testing. Best to just check it all out with your Pulmo.

Not me, if the culture is negative, I chalk it up to a virus. There are thousands circulating, because our damaged lungs are susceptible to bugs that never bother others. For example, I know that "just a cold" inevitably leads to bronchitis, before 7% saline that inevitably led to pneumonia.

In that case, my pulmonologist has me double my nebs for 7 days, and if it is still not gone we resort to a wide-spectrum antibiotic (and possibly another sputum culture.) The ID doc (in the same practice with her) likes this approach. Both are in the camp of "fewer antibiotics. fewer times, helps avoid more drug resistant bacteria."

Does anyone else have a doc who does conservative treatment first in an exacerbation?

BE simply refers to the associated disease called Bronchiectasis. I’m not trying to insult your knowledge I just wanted to clarify for the group. Thank you.

Could be an insurance thing.