Length of Time on Antibiotic Regimen

Posted by lorrie48 @lorrie48, Dec 14, 2024

I was wondering how long the people here have been or had been taking the Triple Cocktail. I'm also curious about the dosages you've been prescribed. I started with 1 azithromycin, 1 ethambutol, and 2 rifampin 3x/wk. Four months in, my pulmonologist prescribed 1-3-2 3x/wk. I expect the dosages to be increased again, since the coughing has increased, not decreased, since I started the meds six months ago. I'd really appreciate hearing about the success of others' treatments.

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@maliko

What are the usual doses prescribed for azithromycin, ethambutol, and rifampin in milligrams (mg) and number of pills for each? Thank you

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I suppose the usual starter dose is 1 azithromycin (500 mg), 1 ethambutol (400 mg), and 2 rifampin (rifabutin 150 mg each) 3x/week. That said, given my reactions or lack of reactions over the last six months, my doctor has had to adjust the dosages a couple of times. I'm currently taking 1-3-2, but I anticipate yet another modification soon.

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@maliko

What are the usual doses prescribed for azithromycin, ethambutol, and rifampin in milligrams (mg) and number of pills for each? Thank you

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Dosage is different for everyone and is mostly dependent upon weight.

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@lorrie48

I suppose the usual starter dose is 1 azithromycin (500 mg), 1 ethambutol (400 mg), and 2 rifampin (rifabutin 150 mg each) 3x/week. That said, given my reactions or lack of reactions over the last six months, my doctor has had to adjust the dosages a couple of times. I'm currently taking 1-3-2, but I anticipate yet another modification soon.

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When you're saying 1-3-2, you are taking 1 pill 500mg azithromycin, 3 pills of ethambutol 400mg (total 1200mg), and 2 pills of rifampin 150mg (total 300mg)? Thank you

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@maliko

When you're saying 1-3-2, you are taking 1 pill 500mg azithromycin, 3 pills of ethambutol 400mg (total 1200mg), and 2 pills of rifampin 150mg (total 300mg)? Thank you

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That's correct.

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Azithromycin 500 mg
Ethambutol 800 mg
Rifampin 500 mg

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@lauraadam2425

I was on the big 3 for 2 1/2 years, but after 1 year was taken off Ethambutol because of eye problems. I was then put on Arycase for 1 year but my cough kept getting worse so I was taken off it. I had my last CT scan about 6 mos ago and it was much better, in fact I was taken off all antibiotics. So far I have beat MAC and at 77 years old I feel I am very lucky. However I did suffer from MAC for 7 years before it was diagnosed, loosing 100 lbs.

Good luck to you and don't get discouraged it can get better. Just remember everyone is different. It may take longer for some and some antibiotics work good for some and not for others. Hang in There!

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I have had a dry cough for the last 7 years. Had Covid the end of March 2023. Still had dry cough in Jan 2024, had CT which revealed a few nodules they thought could be infection. Follow-up CT w/contrast in June revealed nodules in lungs had increased in size and number. Biopsy and wash done in August. Not cancer. Received MAI diagnosis mid-September. (Husband started Chemo so I put my stuff on hold.) I really didn’t want to take these meds after reading all the side effects. Another CT-w/contrast in mid-Nov. showed more nodules. Pulmonary doc said I needed to start meds. So I gave in and started them on Nov 25, 2024.
Azithromycin (500 mg)
Rifampin (600 mg)
Ethambutol (1600 mg)
3 times a week
The vision part scares me to death.
What are the symptoms of eye problems I need to watch for.

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@arkie01

I have had a dry cough for the last 7 years. Had Covid the end of March 2023. Still had dry cough in Jan 2024, had CT which revealed a few nodules they thought could be infection. Follow-up CT w/contrast in June revealed nodules in lungs had increased in size and number. Biopsy and wash done in August. Not cancer. Received MAI diagnosis mid-September. (Husband started Chemo so I put my stuff on hold.) I really didn’t want to take these meds after reading all the side effects. Another CT-w/contrast in mid-Nov. showed more nodules. Pulmonary doc said I needed to start meds. So I gave in and started them on Nov 25, 2024.
Azithromycin (500 mg)
Rifampin (600 mg)
Ethambutol (1600 mg)
3 times a week
The vision part scares me to death.
What are the symptoms of eye problems I need to watch for.

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That's a good question about symptoms of eye problems. I'm going to ask my pulmonologist the same question next week. I feel like my eyes have become more sensitive to glare. I also seem to be having more difficulty with small print on the computer screen ... but that could just be an age thing. I expect it's time for an eye exam.

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Interesting. I have been having more glare for the past week and half.

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@arkie01

I have had a dry cough for the last 7 years. Had Covid the end of March 2023. Still had dry cough in Jan 2024, had CT which revealed a few nodules they thought could be infection. Follow-up CT w/contrast in June revealed nodules in lungs had increased in size and number. Biopsy and wash done in August. Not cancer. Received MAI diagnosis mid-September. (Husband started Chemo so I put my stuff on hold.) I really didn’t want to take these meds after reading all the side effects. Another CT-w/contrast in mid-Nov. showed more nodules. Pulmonary doc said I needed to start meds. So I gave in and started them on Nov 25, 2024.
Azithromycin (500 mg)
Rifampin (600 mg)
Ethambutol (1600 mg)
3 times a week
The vision part scares me to death.
What are the symptoms of eye problems I need to watch for.

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The problem I had was I couldn't pass the vision field test. This is a test where small tiny lights blink at different times in different parts of a screen and you have to press a clicker when you see the lights. I failed 3 tests so my eye doctor immediately took me off Ethambutal and within about 3 months off the medicine I could pass the test.
This doesn't happen to everyone, but it is something to watch for.

Good luck with your meds, they do make a difference.

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I’m asymptomatic but my sputum is positive with MAC Avium and have bronchiectasis in my CT of the chest. I did 6 months of airway clearance and precautions but I was started antibiotics in November since my CT showed not improvement. My antibiotics are three times a week. Now I’m waiting for the first negative sputum and then 12 months from that will continue the antibiotic hoping to tolerate the treatment.
NJH believes I’m a good candidate for antibiotics because I have not symptoms yet and they are hoping for good outcomes. But is definitely a long journey. All the best to you!

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