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Should 4+ Pseudomonas be treated?
MAC & Bronchiectasis | Last Active: Jun 24 7:41am | Replies (115)Comment receiving replies
I’m seeing Pseudomonas as a hot topic lately on the various Bronchiectasis and NTM online forums. Some of the European guidelines recommend early eradication and many doctors follow that approach. But there are other doctors who don’t believe in treating it.
I had this discussion with my NYC doctor who is a specialist NTM and bronchiectasis. She said if I were to culture Pseudomonas that she would start treatment right away. Not even wait for second culture. That’s why I get regular sputum samples.
According to a recent ATS talk by Drs. Chalmers and Blasi, often when we first get Pseudomonas we have no symptoms. So I opt to be proactive with this difficult to kill bug. I think I cleared MAC and prefer not to have any other pathogens taking up residence in my diseased lungs:)
The best of health to everyone,
Linda Esposito
Replies to "I’m seeing Pseudomonas as a hot topic lately on the various Bronchiectasis and NTM online forums...."
In response to @becleartoday …. I have had only 2 sputum cultures since diagnosis in 2018 and have never been informed of any cultures. One culture came back through test results as 2+ positive. I have not had symptoms and the Mayo pulmonologist is see has never addressed this type of issue. I find your approach and doctor’s input very interesting.
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My ID doc is also aggressive when it comes to treating pseudomonas, even when colony counts are low. One of the things that gives me hope is recent and ongoing research about how to make pseudomonas more vulnerable to antibiotics and immune surveillance, by interfering with biofilm formation, efflux pumps, and quorum sensing. Enzymes, herbal meds, pharmaceuticals, and other substances have shown promise, at least in petri dishes. Much more research is needed, including human testing. Numerous entries on Pubmed and other sites. How to safely deliver these substances to the lungs could be a huge challenge.