Discontinuing MAC antibiotics

Posted by Melissa Nelson @melissa08, Aug 6, 2022

For those who have been on the horrible 3 MAC drugs plus Amikacin/Arikayce and terminated usage, was it done cold turkey or did you get off them gradually in the way they were introduced?
Asking on behalf of my husband Bruce who is lobbying his ID/Pulmonologist to either suspend the drugs so he can get out from under the side effects for a bit, or end them completely.
On the up side he has had 7 negative cultures and is no longer producing sputum.
Thanks in advance for your responses.
Melissa

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@helenrivera

Thank you Sue for responding and yes very rough. I so believe my doctors don't understand how bad these make some of us feel. I had a sputum culture done 2x and waiting on result s which can take up to 6weeks. I am praying there negative. I have asked for a break or too go 3× week and my ID doctor discouraged as my cavity was too large and all over the place. I am trying to wait for the 2 different sputums as her pointed out I have only been on the meds 2 months. I expressed since starting I am way worse now than before starting. I started looking up appts at mayo but everything is so far not sure what other lung centers out there and can you please suggest ideas on how to change the way I take the 3 meds and Ariykace as everything I have read is when they 1st started meds, what about 2 months in? I currently take them in the morning and the rifampin and Ariykace in the evening before bed. Should I try taking all at night? Any suggestions will be appreciated. Thank you.

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I take all 3 meds in the evening with one saltine cracker. I have been on the daily regimen, plus Arikayce, for over a month, with little to no side effects. My doctor recommended taking them in the evening to 'sleep off' any side effects that may occur.

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@helenrivera

My 1st culture just in and negative. Praying my 2nd one submitted is also negative.

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Congrats! Hoping for a negative on my last sputum sample after being on Arikayce for a month.

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@pjgottman

Sue, thank you and WOW! I made a huge assumption (and mistake?) that the ID Doc I was being referred to by the Pulmonologist was a specialist in MAC. I never even asked if he was! Also - no- there has been no discussion of a daily airway clearance routine or any other treatment beyond these three antibiotics. Again, if I don't know to ask, information has not been offered.

I did call today and said I needed to talk about other options - hope to talk to a human being at some point. In the meantime, I have taken myself off this approach. I expect I will feel much better in 24 hours. I have a lot to learn here! Thank you for helping to educate me. Pat

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Sadly, since MAC is an orphan disease, very few community docs have much knowledge or expertise in treating it. You're best off going to a COE (center of excellence), where MAC is their bread and butter. National Jewish Health and UT Tyler are two of the best centers in the US

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@sueinmn

Cold turkey! I never had a negative culture, just got to the point where I could no longer tolerate the side effects and my lungs were looking "better".
I have stayed healthy for 20 months now with 7% saline nebs, mucus thinning meds and airway clearance.
Recovery from the side effects took another year, but I began feeling better within about 2 weeks. I don't know if I would ever take the big 3 again...
Sue

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You said you took mucus thinning meds.
What did you take?

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@kaykuz

You said you took mucus thinning meds.
What did you take?

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I took, and still take, guaifenesin (without other ingredients) and N-acetyl cysteine (NAC.) This is something you should discuss with your doctor as far as dose and safety for you.
Sue

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@sueinmn

I took, and still take, guaifenesin (without other ingredients) and N-acetyl cysteine (NAC.) This is something you should discuss with your doctor as far as dose and safety for you.
Sue

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I take NAC. He just increased my dosage to two twice a day.
I was prescribed mucinex in hospital by doctor on call. But my pulmonologist did not recommend it

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@kaykuz

I take NAC. He just increased my dosage to two twice a day.
I was prescribed mucinex in hospital by doctor on call. But my pulmonologist did not recommend it

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I find the Mucinex does more to help than anything else I have taken. With 4-6 glasses of water daily it thins the mucus - before using it I had a lot of problem with mucus in my sinuses and ears too. My pulmo was skeptical too, until I explained how much easier it made clearing out the crud. Did they say why it wasn't recommended? Note- I only use plain guaifenesin - no decongestant or cough suppressant in it.

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@sueinmn

I find the Mucinex does more to help than anything else I have taken. With 4-6 glasses of water daily it thins the mucus - before using it I had a lot of problem with mucus in my sinuses and ears too. My pulmo was skeptical too, until I explained how much easier it made clearing out the crud. Did they say why it wasn't recommended? Note- I only use plain guaifenesin - no decongestant or cough suppressant in it.

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No, just that he prefers not to use it..
But if it works for you then that is good....
Do you have thick sticky mucus?

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@kaykuz

No, just that he prefers not to use it..
But if it works for you then that is good....
Do you have thick sticky mucus?

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Yes, untreated my mucus has almost the consistency of rubber cement. It is a family characteristic - my Dad and 2 brothers, my brother, one daughter, now my grandson seems to have it. My daughter was actually tested for CF genetic markers because of it. (No CF)

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@sueinmn

Yes, untreated my mucus has almost the consistency of rubber cement. It is a family characteristic - my Dad and 2 brothers, my brother, one daughter, now my grandson seems to have it. My daughter was actually tested for CF genetic markers because of it. (No CF)

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I have it to. Some days worse than others and sometime none. Or it’s not coming up.
Latest Scan showed more bronchiectasis in the lower two lobes and pulmonologist thinks I have more mucus there and also MAI most likely. That’s why he started me on the vest.
I did have my virtual visit with him on Wednesday. I told him that I was surprised that I have had MAI since last September. He kept telling me I didn’t. But then he said that my two cultures in the fall were negative.
I am starting my regimen tomorrow evening.

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