Time of day to take big 3

I have been treated for pseudomonas three times over the last 14 months, twice with Cipro and once with Levofloxacin and inhaled Tobramycin. I have heard that pseudomonas is very difficult to cure so I believe that my pseudomonas is never really gone, just knocked back for a while. I couldn’t tolerate the tobramycin because it caused severe shortness of breath. Each time I have been treated for pseudomonas the doctor told me to stop the MAC medications and then slowly restart them, first with azithromycin for one week, then add ethambutol for another week and then add in the rifampin. I’m sure the pseudomonas will return but I’m hoping to complete my MAC treatment before I have to treat it again.

I should have also told you when you start treatment, take azithromycin for a week by itself, then add ethambutol for a week and finally add rifampin. This may help the GI issues. Also, have you discussed with your doctor taking the meds only 3 days a week. That is much easier to tolerate but your doctor may have specific reasons for taking them daily.

Thank you for your replies! I did ask about 3x a week but she is insistent on daily. I think because i have a cavitation even though i am asymptomatic. She also stresses that i have to start all 3 meds within 24 hours of each other. I took ethambutol and azithromycin for the first time tonight and will take the first dose of rifampin tomorrow morning. Fingers crossed that i cann tolerate this.

Thanks for your post.
If I start the two antibiotics I was wanting to take them all at the same time and wondered....so glad you posted your routine. Taking the 2 antibiotics in the AM all at the same time is what I will try....if...(still saying that)...I take the antibiotics.
One thing though...for me mornings are all "used up" for doing what one needs to do for caring for oneself with BE/MAC, educating oneself if having questions and concerns, food preparation, food intake and antibiotics if wanting to take them all at the same time to allow for having other required and wanted nutritious foods the rest of the day and while trying to eat just small meals as they suggest.
Same here....no eat or drink 3-4 hours before bedtime due to hiatal hernia.
Challenges we have been given and why we often say to each other "Hang in there."
Barbara
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Barbara,
you are absolutely right! It’s quite a task to keep up with all the routines and doing the right thing.
The good side is that it seems to get easier as time goes by.
I started the antibiotics in November and that was not an easy decision but I decided to trust the doctor. So will see

I, too, hope you can tolerate jumping into the deep end of the "Big Three Pool". Like so many others, my doctor started me on typical dosages 3x/wk, after introducing each of the meds one week at a time. Unfortunately, I reacted with tremors, nighttime chills, and fatigue after I began adding the rifampin. He took me off everything for two weeks, and then we started the regimen all over again. He's since increased the ethambutol, and I see more increases in my future. Hopefully, your doctor will do similarly if you have trouble.

Thanks everyone for all the comments, after 6 months on the big 3 , my sputum test came back negative for MAC , but told to continue on the 3 meds. This is how I take my meds , in the morning around 0630 I take the Refampin ( to be taken on empty stomach) with lots of water ,then wait an hour eat crackers then take the Ethambutol and Azithromycin with lots of water, then after breakfast take my morning meds. At bedtime I take Tums, seems to help discomfort from the pills. Sometimes I have loose stools, I just eat rice and bananas seems to help,also take protein supplements to keep my weight. But now with my BE exacerbation my pulmonologist due to some abnormalities on my sputum tests, ordered Tobramycin inhalation , still waiting for the medicine . We hope and pray that those medications on clinical trials be available soon. Been praying for everyone, have faith in God 🙏 .

Thanks for sharing when and how you take your meds. Because my doctor told me when and how didn't matter, I've been taking all three at lunch. Yes, they unsettled my stomach a little, so Tums became a thing. Then, I discovered Bio Salud as a probiotic. It's easier for me to handle than yogurt, and it seems to be easing the bloating brought on the meds. It has made Tums unnecessary, at least for me. 🙂

Good morning Mary Jane. Just read your question. I’ve been taking the big 3 three times a week since April; that’s for 8 months now. I haven’t had any issues with it. To answer your question, I tend to take the big 3 about a half hour after a meal, whether it’s breakfast or lunch. When I first started, I had the runs a few times only. I didn’t worry about it and it dissipated quickly. Hope you feel better soon. Josie