Should 4+ Pseudomonas be treated?
Good morning to all. I'm wondering what experiences you've had regarding treatment on recurring Pseudomonas. I had just finished treatment for 3+ Stenotrophomonas Maltophilia and wanted to know if the treatment had gotten rid of it. I did not hear from my pulmonary doc about results of my last sputum--testing had begun on June 19th. Last Friday I went on the portal and this is what I found. FINAL REPORT: 4+ Pseudomonas aeruginosa. This is the 5th Pseudomonas since March 2019. I had a result of
3+ Pseudomonas Aeruginosa in March this year and I was put on Tobramycin for
28 days. Now I show 4+ and have not heard from anyone from the doctor's office. I contacted the doctor by portal to question if treatment was indicated.
I feel OK, no noticeable shortness of breath, am nebulizing 7% Sod. Chl. once a day, appetite not great but OK (basically normal for me). I rarely cough up anything of color after nebing--maybe pale yellow, if at all. Over the last week or so (a few times a day) I have just a very slight dry cough. Otherwise am asymptomatic. The doctor responded "I would say at this point that we should not treat unless something changes clinically. We can discuss more at your next appointment but please let me know if your symptoms change.” Any experiences out there to share?
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@fdixon53 and @auntnanny, Hi there! All of these micro-organisms that invade our bodies are such a drag!!! You two gals have sure had a time of it battling these bugs over the years. If I could reach through this computer and give you a hug, I would. Toby was my salvation, but apparently, I am not the norm. I had pseudo back in 2016 and after 28 days on the tobramycin, I tested negative. Mayo kept me on that antibiotic for five more years on alternating months at 28 day stretches. I remained on the toby as a prophylactic measure. I was taken off of it and my other bi-monthly antibiotic last Dec. 2021. I had stayed clear of everything. (I had been negative for MAC since 2014). Guess what? Since going off of the maintenance antibiotics, I now have tested positive for MAC and aspergillus. The reason I was taken off all antibiotics is that Mayo believes that I may be nearing the time of needing a lung transplant and they do not want me building up a tolerance to the meds post-op. I feel like I need some protection still as I do not want my lungs to deteriorate faster due to infection. I go back to Mayo next week for more tests to see if I am any closer to needing to get listed for transplant, and I will ask about the dilemma of using antibiotics at this stage of the game.
Once Pseudomonas becomes mucoid strain nothing will eliminate it (according to my Pulmo). But ongoing treatment (prophylactic) can help to keep it down. That is if you can tolerate the usual ongoing treatment options (which i could not). Or I suppose a yearly course of oral or IV antibiotics as needed might help (again if you can tolerate it). I currently only do airway clearance with saline and aerobika and positional drainage.
I've been on 4 rounds of antibiotics and I have the same thing. It comes back after a couple of days. Did you get rid of yours and how did you do that?
Have you been treated with inhaled Tobramycin or Colistin? If not, maybe a visit with an infectious disease specialist is in your future?
Hello liebekin. I understand that every patient is different but also every doctor seems to have a different approach to treatment vs not treatment. I started showing pseudomonas in January through march. The NJH doctor dr Griffith said if it’s colonized they don’t treat it. The march sputum test did not show it. Instead it showed aspergillus. Dr Griffith said no treatment. My local I’d doctor is against treating pseudomonas aspergillus or anything colonized unless it gives you serious symptoms- she says they get resistant and that we always have something in our respiratory system. So when I got sick in may despite showing aspergillus on the culture I was given levaquin because NJH doctor thinks that if you have it it’s the usual cause of the infection. Could it have been aspergillus I don’t know but levaquin helped ( aspergillus is yeast so levaquin is not the med). It’s a long post but my point is when we get sick we take what the doctor prescribes no matter what because we want to get life back. I hope your doctor is wise and knowledgeable to help you.