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?