stay on low dose antibiotic indefinitely for chronic cough.

Posted by mirsy @mirsy, Mar 29 9:55pm

My 80 yr old husband has bronchiectasis and the chronic cough is driving him nuts. He was recently on an antibiotic twice and each time the coughing stopped and it was wonderful for him. Is it possible he could stay on a low dose of an antibiotic indefinitely to keep cough from coming back?

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Sue, Volunteer Mentor | @sueinmn | Mar 30 4:00pm

@mirsy It depends! Has he been evaluated via sputum culture to determine what infection(s) he might have in his lungs that are causing the cough. Does he do daily airway clearance using a nebulizer and breathing exercises to get the mucus out? If not,this might help the cough.
If he has pseudomonas or a fungal infection, it may need to be treated with an appropriate drug. If he has a Mycobacteria infection (we abbreviate it NTM or MAC) it needs to be determined whether long-term drug therapy using multiple antibiotics is needed.

How is his overall health and lung function.

bayarea58 | @bayarea58 | Mar 30 6:37pm

@mirsy I agree with others comments. If your husband has not been evaluated for infection, then this would be top of my list. As someone with NTM, I would always suggest that if an antibiotic is prescribed for a patient with BE, if possible, it not be azithromycin, as NTM is very difficult to treat without azithromycin and as Scoop points out, one can develop a resistance to azithromycin over time. I know some doctors treat BE with low dose azithromycin, but to me, and many NTM experts, it is risky to do so as no one knows who with BE may be susceptible to an NTM infection and having BE is itself a risk factor for developing an NTM infection.

mirsy | @mirsy | Mar 30 6:59pm

In reply to @noisylungs31 "Three more days to go." + (show)

will cross my fingers the effects of antibiotic will linger for a good while for you! Please keep us posted.

mirsy | @mirsy | Mar 30 7:03pm

In reply to @sueinmn "@mirsy It depends! Has he been evaluated via sputum culture to determine what infection(s) he might..." + (show)

His last sputum culture awhile back came back negative. Yes he uses saline solution w nebulizer and then vest. He had pseudomonas last year and was treated for it. Right now he is using nebulizer, then vest and has added Q-var which seems to give him relief from the cough thank goodness.

mirsy | @mirsy | Mar 30 7:06pm

In reply to @sueinmn "@mirsy It depends! Has he been evaluated via sputum culture to determine what infection(s) he might..." + (show)

forgot to mention he is getting a leadless pacemaker this Wednesday for a slow heart rate and shortness of breath. He also has CLL and diabetes. He has alot on his plate and is 80 so we cant expect too much I guess but of course we are hoping he will get some relief to enjoy the time he has left here. Thanks for your help.

mirsy | @mirsy | Mar 30 8:42pm

In reply to @bayarea58 "@mirsy I agree with others comments. If your husband has not been evaluated for infection, then..." + (show)

Thanks for your reply - I can now see this a complicated illness. I will discuss it with the pulmonologist who must know about the azithromycin & NTM.

lenorj | @lenorj | Mar 31 6:53am

In reply to @mirsy "Thank you for your reply. Are you on a low dose antibiotic now for your cough?" + (show)

I am not currently on an antibiotic, but each time I have been on one, even for a sinus infection, my cough has been much better even for a week or so after the antibiotic.

Sue, Volunteer Mentor | @sueinmn | Mar 31 10:16am

In reply to @lenorj "I am not currently on an antibiotic, but each time I have been on one, even..." + (show)

My ID doc attributed the reduced cough to the anti-inflammatory effect of many antibiotics. In other words, it is not really treating an infection, it is reducing the inflammation/irritation in the lungs/trachea/throat.