The Constant Cough Question

@rebecross How's your clearance routine? Often incomplete clearance can result in coughing throughout the day. Constant coughing also makes me think of is post nasal drip or under treated reflux disease.

I use an aerobika with 3% saline (pulmonary says she doesn't think I need the 7%) and huff coughs at least once a day, or when ever I feel tight. I bring up 1/4 cup or more white frothy goodies, routinely, plus more while coughing throughout the day AND night. I'm a month into Azithro,(250, MWF) and think it MIGHT be affecting the amount I clear. (More than before).Also do use 2 nasal sprays, which have reduced night time post nasal drip, don't have much of that in the daytime, and I can tell the difference between what drains from my head and what slithers up from my lungs.

Oh yeah, reflux, been vetted by GI, including a24 hr ph test, nothing they found!

@rebecross I hear you about nose vs lungs origin! My pulmonologist did not think I needed 7% either, thinking it was too harsh. Once I convinced him to let me have a trial, it made a world of difference. Nebbing 7% using the aerobika (flutter type device) inline with a nebulizer following by clearance autogenic drainage and huffing. It's not for the faint of heart! Time consuming and frustrating but necessary to keep me as well as possible (keeping yucky bugs at bay) and prevent daily coughing fits.

Thanks so much for sharing your experience!

I'm probably coming into this conversation late or missed something, but I don't understand how azithromycin (an antibiotic) would help with coughing?

Right, AZ is not a cough suppressant but treats the MAC bacteria, pneumonia, etc. AZ IV has saved my life 2 times.

It is time consuming and really affects my ability to do all the things I want to do. And I am resentful, BUT I know I MUST do it if I am to stay free of infections and out of the hospital. It's what it is and I deal with it.

I'm sure taking AZ 3 days a week has saved me as well.

I copied this from a medical journal article written in 2022. As patients we *possibly* have enough knowledge to understand some of its meaning. Maybe not. I hope it's helpful to someone!

"For patients with substantial daily symptoms and frequent exacerbations (three or more per year), additional therapies may be required to improve quality of life and prevent further lung damage. In a meta-analysis of three randomized trials, investigators found that the use of macrolide antibiotics reduced the frequency of exacerbations and increased the time until the next exacerbation. Improvements in quality of life were also documented in those trials. The mechanism of action is unclear, although macrolides may inhibit quorum sensing by P. aeruginosa. The usual dosing regimen is azithromycin at a dose of 500 mg three times per week or 250 mg daily. Although the studies were conducted for only 1 year, it seems that macrolides are generally safe and have an acceptable side-effect profile over longer durations. However, caution must be observed when prescribing macrolides, given the risk of resistance and gastrointestinal, cardiac, and auditory side effects. Macrolide monotherapy should not be used when nontuberculous mycobacterial infection is present or has not yet been ruled out."