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Should 4+ Pseudomonas be treated?

MAC & Bronchiectasis | Last Active: Jun 24 7:41am | Replies (115)

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@rits

Hi gang, I would appreciate some advice regarding pseudomonas treatment. I picked up this nasty bugger while hospitalized for a rhinovirus (cold) for 17 days. It first showed up in April 2019 and continued showing up in the monthly samples I brought in while I was being treated for MAC. It disappeared in September 2019. I think it didn't like Arikayce which I began taking in August,

I stopped all MAC treatment at the end of May 2020 almost 15 months after I started and a year after it vanished from my samples. Unfortunately, pseudomonas reappeared in my June 2020 sample (mailed 4/20), my August sample (mailed 7/27), and most recently 11/20 (mailed 10/20). I had a video appointment last week with Dr. McShane who is treating my various lung organisms from UT Tyler. My breathing has been horrible and getting worse for months with lots of shortness of breath and almost constant thick, gross but clear, sputum. Is it the pseudomonas (or the bosa nova - sorry couldn't resist Thumper's influence).

Dr. McShane is reluctant to treat. I had a lot of trouble with the oral antibiotics, mainly digestive, that has improved only over the last few weeks. I had a great deal of trouble with Arikayce which affected my breathing so Dr, McShane is also reluctant to prescribe an inhaled drug. My pseudomonas is susceptible to every antibiotic on the list, But, she said that she has been "chasing bacteria" like pseudomonas since she first started practicing in this area in 2008. She said I could do a course of antibiotic and the numbers would go down enough so that it wouldn't show up in the report. However, soon after stopping the antibiotic, the numbers would go up again in a vicious cycle,

Instead, she prescribed a prednisone burst which has given me loads of energy but seems to have made the humongous amount of sputum worse, I'm breathing through cement! I'm finishing the burst tomorrow and promised I would report on how I'm doing. Dr. McShane is brilliant and probably the best doctor I have ever had and, believe me, I have been treated by A LOT of doctors. If I tell her that I want to try treating it, I believe she will prescribe something although we aren't sure that it is the pseudomonas causing this. Also, I am overdo for a chest ct scan which would be helpful but I am too stressed to have any tests until after I have confidence I will be safe. That, hopefully, will be in a couple of months.

I hope Terri and others who have a pseudomonas history will chime in. Should I push for treatment? Thanks

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Replies to "Hi gang, I would appreciate some advice regarding pseudomonas treatment. I picked up this nasty bugger..."

@rits...I noticed you haven't gotten the replies you are seeking. It is frustrating. Your doctor sounds like an excellent source for appropriate medicines. Those of us who have constant mucous and are denied antibiotics for good reasons (candida, side effects, etc) have had to turn to alternatives such as postural drainage (see youtube videos), lung cleanse (see amazon), mucinex, and change in diet (acid reduction). You can take control over what you do every day. This will help you feel less helpless. I hope you find your answers.

CT scans are super quick. I have had to have several since Covid, and I schedule them to be first appointment in morning. I do not feel nearly as exposed as most places.

@rits I just found this article on Phage therapy for Pseudomonas from Cystic Fibrosis News today. Unfortunately not something available today but maybe in the near future. Not an antibiotic, YEAH!!!!. https://cysticfibrosisnewstoday.com/2021/01/12/phase-1-2-trial-at-yale-testing-phage-therapy-chronic-p-aeruginosa-infections-in-cf/ Phage therapy is also being tested for treatment of Mycobacterial infections. https://www.genengnews.com/insights/phage-therapy-win-mycobacterium-infection-halted/

Hi Rits... I too have pseudomonas that is colonized..I would ask the dr to give you Ciprofloxacin for 2 weeks, to try and get rid of it..it sounds like you are also have symptoms.. I get sputum turning green tightness in my chest, and trouble breathing..doing nothing isn’t how I would be dealing with it..Cipro and levaquin are first meds given for 2 weeks.. if it has shown in your sputum 3 times, as well as symptoms it should b3 tim3 to try Cipro for starters

Hi Rita. I am no physician as you well know, but it appears to me that you are not being left on the antibiotic long enough to truly stamp out the pseudomonas. I was put on tobramycin in 2016 to treat mine. I felt better and all coughing ceased after one month on it, but my dr at Mayo would not take me off off it until the spring of 2020. Remember, the reason you are suseptible to pseudomonas doesn't go away with medication. We have damaged lungs and will forever be fighting against opportunistic pathegens. I had been on both cipro and tobramycin for four yrs to get it good and gone.

Hi all, what Aerobika device should I buy

Hi, Earlier this month while in the hospital from a MAC flare up they found pseudomonas and my doctor put me on Cipro for ten days. All my research said one should be on it 4 to 6 weeks to kill this nasty bug but my doctor was reluctant to keep me on it longer as she said it could cause damage to the kidneys. They then changed the diagnosis to pneumonia pseudomonas and said let's watch it after the course of drugs. Around day 7 I started feeling a bit better although still very weak. I've been off the drugs for a week now and while still not 100% I'm much better than I was. I am still weak and get tired very easily. Still coughing, etc. Have an appointment next week with the new lung doctors from the hospital for a second opinion.

Meanwhile, in my own research I found an article about Manuka Honey from New Zealand that claims to kill the pseudomonas bacteria. After being diagnosed with asthma, COPD, MAC and now pseudomonas with little luck tolerating the drugs they have tired, I ordered a jar of the honey. Figured it can't hurt to try and if it helps all the better. Has anyone else heard of this or tried it?

There was some success reported in treating pseudomonas in skin infections using Manuka honey. That led to the hope that it might also be effective at treating pseudomonas lung infections because people with Cystic Fibrosis, COPD and bronchiectasis are susceptible to them.
I was a little skeptical of the theory - putting honey on the bacteria on the skin (or in a petri dish) seemed vastly different than trying to get it onto the bacteria hiding deep in lung tissue. This brief report: https://cronfa.swan.ac.uk/Record/cronfa50103 seems to say just that.
"Ex vivo" means "outside the body" - tests performed there showed that honey plus antibiotics placed on the bacteria inhibited growth. Unfortunately, there doesn't seem to be a way (yet) to deliver the antibacterial properties of the honey into the lungs. That difficulty is described here: https://www.labroots.com/trending/microbiology/14893/manuka-honey-kills-cystic-fibrosis-pathogens-culture
As with all things in medicine, stay tuned for further development.
Sue

I have been dealing with this for years and finally had someone test my sputum and consistently find pseudomonas aeruginosa. I have exhausted all tests that I know, even did every genetic test possible with everything negative. I am now on Azithromycin 250mg daily to function, but this is taking so much of my life away and I am still with no answers why. Are there any other tests that can be done? Mycobacterium Gordonae and haemophilus influenzae were also found. Should I seek more help from the Mayo Clinic that maybe I’m not getting?

Pseudomonas is considered an opportunistic infection. It primarily settles in where something else has compromised you lungs and or sinuses.
As I mentioned above, not every doc is familiar with progressive treatment. The Gold Standard for treating these is National Jewish Health, Mayo and a few other major centers. Since your local docs have been unable to arrive at a diagnosis and effective treatment, it is certainly time to ask for a referral. With how crowded and tightly scheduled facilities are these days it may be better to have a referral than to self-refer. In what part of the country are you located.?