Has anyone started on or ever used the IV antibiotic infusions?

This is my third round of treatments for M. abcessus and in two of the three IV antibiotics were given via PICC line. I currently am using a PICC and actually prefer it because, for me, the nausea is much less. There is the inconvenience of having to keep track of the medications I use here at home but I figured out a routine. I run the first one during my morning Huff Vest routine and the other with the evening so the time commitment is less. The technology for the home IVs is super easy and once you are used to handling the lines there is no stress . For me the trade off to have fewer side affects is a simple one

@smtdoc
Wow, thanks for sharing your experience, I feel much less stressed. So you administer them yourself? I thought home health or you had to go somewhere to be administered.
Sounds like you administer them 2x/day? How long does it take and what side effects do you have? You mentioned nausea was less by IV than oral? I so appreciate you sharing as I was feeling so alone on this journey. Any other tips, ideas or suggestions, please share. I really am nervous to start these.

I have bronchiectisis as well as pseudomonas. I just recovered from the worst flare up. I've had, it lasted 6-8 weeks. When it first started I was on ciprofloxin
for 7 days. A week later I knew it had not worked. Turned in another sputum which came back positive for pseudomonas. I then was put on IV infusions of cefepime 2 grams every day for 2 weeks thru a midline. It took thirty minutes every day at the infusion center. It still didn't work. A week later infection control was consulted they said it wasn't a high enough dose, nor long enough. I was then put on IV infusions of cefepime 6 grams with an IV pump thru a pic line that I had to wear 24/ 7. But I had a bad reaction after a week, spent three days in the hospital under observation till the rash had cleared completely from my body. Infection control then recommended 2 more weeks of Fortaz 6 grams with the IV pump 24/7. That finally did the trick and my sputum came back normal. Having to wear the pump all the time with the tube wasn't too bad. I had to be careful I didn't catch it on anything, so I learned to be very careful. I think the hardest part was not being able to take a shower. You have to keep the pic line, totally dry and clean. I tried using one of those plastic sleeves but it was so tight above the pic line I was afraid of it, cutting off the circulation. So I resorted to standing in the shower and using the handheld to wash as best I could without getting my arm with the pic line wet. The other problem was I had to go to the infusion center every single day to get the antibiotic bag changed. It wasn't too bad, just one more thing to work into a day.

From the previous comments, it sounds like physicians are taking a variety of approaches to using IV antibiotics. My first experience was in 2002 when I did 6 months of twice a day (5 days a week) Amikacin for MAC (along with 3 oral antibiotics). A PIC line would have precluded swimming, so I argued for a “port” inserted in my chest wall. I’m an RN so I knew how to access the port …. I doubt this would be an option for others. It got rid of the MAC.
In 2023 I did 3 weeks of every 8 hours Ceftazadine (2 mg) for resistant pseudomonas. I had a Midline (lasts longer than a PIC) inserted, self-administered at home, with a dressing change once a week at the infusion center. The plastic sleeve worked ok, with rubber bands. (It’s not the end of the world if a dressing gets a little damp.). The pseudomonas wasn’t eliminated but I was much improved. I repeated this routine once in 2024, twice in 2025. My Infectious Disease specialist prescribed and supervised all of these treatments. This spring a new pulmonologist suggested nebulized Tobramycin, twice a day for 28 days, then 28 days off. I’m now on my third cycle with amazing results…. I don’t cough up anything!!! I expect we will do a sputum specimen next month and perhaps be able to stop treatment.
Ask a lot of questions, work with an ID doc as well as a pulmonologist and be prepared for a long haul. Bronchiectasis is a major nuisance.

@vstankie - What I do for showering with a PICC. Wrap the arm with saran wrap. Then take a fairly wide, light weight, i.e. masking tape around the top edge and bottom edge. I've had 2 PICC lines and two midlines for infusion and the area has never gotten wet.

@fdixon63 do you have someone helping you to wrap it with saran? And tape? I tried that. I have a hard enough time with saran wrap using two hands let alone one.

It all feels overwhelming at first but at home is easy and by the third or forth day, its just like any other routine and so much more convenient than driving some where, parking, waiting. etc. Once a week the pharmacy sends me everything I need and its like a familiar recipe. You do the same things in the same order each time. In my case the antibiotics were Nuzyra (very nauseating for me) and Amikacin. Each daily dose is in a plastic ball about the size of a lemon. It is set to release at the right rate. There is no need for a separate machine to control the rate
I have a protective wrap I bought for the PICC (looks like a black arm band around my bicep) and I open it to free up free up the PICC tubing. I follow the recipe to get ready , connect the line, open the clip and set a timer for the run time (mine were 30 minutes each) and then I read, work on the computer, etc. and when the timer sounds, I reverse the process and get on with the day. My PIC has two lines because I use two different antibiotics.
Minimal side effects. Now I am able to give the orals a try again but still have thePICC just in case. More anxiou anout the orals than the PICC

@mffox you mentioned producing a sputum next month …is there an easy way to produce a sputum ?
Thank you . Kay B.

@kaybast

@mffox