How to clean nebulizer supplies?

@carolmj @bronchiectasaurus @pacathy @grammyvictoria @legacygsh1 @rockinkranch @jackie7926 @nickraosr @melinda561 @smc17
Hello all, I have been watching this conversation develop for several days. How, how much, and how often to clean nebulizer equipment, spacers, Aerobika and similar devices, and nasal lavage equipment is a HUGE topic on all of the Bronchiectasis discussion groups, and even among experts.
Y'all have heard far too much from me over time about what I do and why, and many of you know I am on the high end of risk tolerance, so I'm noy adding my unscientific opinion here.

But, STAY TUNED FOR FURTHER INFORMATION. By way of the NTM Info organization, two noted experts in the field, Dr Jennifer Honda and Dr Joe Falkinham and their staff are testing various cleaning and sterilization methods, and hopes to release a definitive report soon.

In the meantime, washing/soaking alone is not enough to eliminate NTM and other pathogens, especially if you already have an infection. But, it is "up in the air" whether daily sterilizing is necessary, how long to boil, which baby bottle sterilizers or microwave bags are best, whether you need to dry the parts after sterilizing, whether vinegar or alcohol work (and at what concentration/for how long.)

Regardless of what you may read on other forums, I'm sorry there is no single answer right now, but be patient.

@sueinmn Well, this is good news that the experts are going to release a definitive report on how to properly clean a nebulizer when you have MAC. My head is spinning over the different pieces of information. I've tried several methods but so far I prefer using the steam bags on high for 5 minutes for the nebulizer parts but I'm not sure that this is 100% effective. It would be nice to use the baby bottle sterilizers that disinfect and dry but the highest rated ones seem to be hard to find and Pari told me not to use. They only recommend boiling. I'm looking forward to seeing the report, Sue. Thanks for all of your help on this forum, along with all of the other folks who have shared their experiences. I'm a new patient for MAC and bronchiectasis and I've learned a lot from reading the discussions.

Thanks for responding. I undoubtedly just threw away a set that was perfectly fine, because I always sterilize after every use, no exceptions. I tried to do a little research on why the company has a 6 month recommendation for lifespan. My research was limited to looking at patient forums and various discussions, because there don't see, to be available scientific studies about this. There seems to be a concern (by patient members within these varius forums) about biofilms growing that are attaching to the equipment and not readily removed through the ordinary cleaning process. I suppose that's more likely if you're only soaking in hot dish soap water and not sterilizing in any manner. I try to gently scrub the pieces with a proxy brush (interdental) I've dedicated for this purpose. But you can't get into the intricate areas. Then rinse. Then I boil for 10 minutes. Hopefully, because of the boiling, my equipment is less likely to grow or maintain these biofilms that can harbor the harmful bacteria. I keep trying to do the best job I can do, but if I were doing more than once a day nebbing, I don't know that I could keep this up!

I have two neb cups and 2 Aerobikas in constant rotation. I neb with Aerobika 2x day. I soak in Dawn antibacterial water at least 15 mins, rinse, put in Instapot 12 minutes at pressure cook then dry in Wabi dryer 70 minutes. This works for me as I have the dedicated Instapot and Wabi UV dryer in the room where I do airway clearance.

I have been able to sanitize my nebulizer equipment using the same UV device I use for my CPAP. With the added drying cycle, it takes just over one hour. The devices are not very expensive and are certainly convenient!

Fortunately, we have lots of sterilizing options!!

If we believe there is only one way to sterilize our equipment and that it requires very specific home equipment, we may unintentionally limit how freely we live our lives.

For many of us, life includes travel, spending time with friends and family, and enjoying activities outside our homes. It’s incredibly helpful to know there are multiple effective sterilization options, and what we choose may depend on where we are.

For example, when I’m home, I typically use a baby bottle steam sterilizer. But when I travel, I may boil, use steam bags, or use a cold sterilization technique depending on what’s practical.

That kind of flexibility matters to me. It allows me to protect my health while still living the life I want to live.

If you’re primarily home-based, this may not feel as important to you. But even then, it’s empowering to know there are excellent options available.

Knowledge creates flexibility… and flexibility can create freedom.

Linda Esposito

Thanks for responding. I undoubtedly just threw away a set that was perfectly fine, because I always sterilize after every use, no exceptions. I tried to do a little research on why the company has a 6 month recommendation for lifespan. My research was limited to looking at patient forums and various discussions, because there don't see, to be available scientific studies about this. There seems to be a concern (by patient members within these varius forums) about biofilms growing that are attaching to the equipment and not readily removed through the ordinary cleaning process. I suppose that's more likely if you're only soaking in hot dish soap water and not sterilizing in any manner. I try to gently scrub the pieces with a proxy brush (interdental) I've dedicated for this purpose. But you can't get into the intricate areas. Then rinse. Then I boil for 10 minutes. Hopefully, because of the boiling, my equipment is less likely to grow or maintain these biofilms that can harbor the harmful bacteria. I keep trying to do the best job I can do, but if I were doing more than once a day nebbing, I don't know that I could keep this up!

@ursala7 My experience is that the nebulizers start to leak after about 6 months or so. You can rotate the top of the aeroclipse from the arrow (with all the dots) to the arrow (solid-no dots) and the saline will just vaporize continuously. So, you will start to lose a lot of the saline. I have 8 aeroclipse nebulizers and 1 aerobika. I use the aerobika only to blow in (not inhale) after I nebulize with the aeroclipse. I soak in warm soapy water, rinse, and put aside and 2/week, I boil just the aeroclipse tops. The containers and mouthpieces, I put in the BOLOLO bottle sterilizer and disinfact that way. I know many put the aeroclipse tops in the BOLOLO, but I don't believe it has been proven to kill NTMs inside the aeroclipse. Jennifer Honda from UT-Tyler, did mention that they might get to-someday.