Pseudomonas aureginosa: When did your doctor decide to start treating?

Posted by lilianna @lilianna, Nov 27, 2023

When were your pseudomonas treated and how did your doctor decide it was time to do it? I have bronchiectasis, MAC and was diagnosed with pseudomonas in August. My pneumonologist thought it was colonized and I did not have symptoms so she decided not to treat it. I had my sputum culture last week and again pseudomonas was grown. Now she wants me to decide if I want treatment with Cipro if I think I need it. How do I know if I need it? I asked if they counted the size of colonies (I don't know if they even ever do it) but the nurse who called me did not know the answer. So if you had pseudomonas, please respond to my post and share how yours was delt with. I am scared to start another antibiotic and is it better to start early the treatment or wait for symptoms (what kind?)?

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Hi Lilianna. I have MAC and bronchiectasis and have bronchoscopies almost every year. In 2018, I was found to have pseudomonas and my pulmonologist treated it right away with a course of an antibiotic. Subsequent bronchoscopies have been clear of pseudomonas.

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@jeanarizona

Hi Lilianna. I have MAC and bronchiectasis and have bronchoscopies almost every year. In 2018, I was found to have pseudomonas and my pulmonologist treated it right away with a course of an antibiotic. Subsequent bronchoscopies have been clear of pseudomonas.

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Thank you for your response. What antibiotics did you start the treatment with. Did they count the concentration of the bacteria or they did not?

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@lilianna

Thank you for your response. What antibiotics did you start the treatment with. Did they count the concentration of the bacteria or they did not?

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I am sorry but I don't remember what antibiotic I took for pseudomonas. The Lab result says 1+ Pseudomonas Aeruginosa and it was susceptible to Ceftazidime, Cipro, Gentamicin, and Meropenem.

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@jeanarizona

I am sorry but I don't remember what antibiotic I took for pseudomonas. The Lab result says 1+ Pseudomonas Aeruginosa and it was susceptible to Ceftazidime, Cipro, Gentamicin, and Meropenem.

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PS. I don't remember taking anything exotic for it.

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@jeanarizona

Hi Lilianna. I have MAC and bronchiectasis and have bronchoscopies almost every year. In 2018, I was found to have pseudomonas and my pulmonologist treated it right away with a course of an antibiotic. Subsequent bronchoscopies have been clear of pseudomonas.

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What antibiotic were you treated with?

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@sweethighland

What antibiotic were you treated with?

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I don’t remember what I took for pseudomonas. Now taking Azithromycin, Rifampin, and Ethambutol for MAC.

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@jeanarizona

I don’t remember what I took for pseudomonas. Now taking Azithromycin, Rifampin, and Ethambutol for MAC.

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Thank you.

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When I asked my pulmo if colonized and chronic Pseudo were the same thing he said yes. But are they? And why do you not treat colonized unless symptoms? I do know that early treatment of Pseudo can prevent it from becoming what I would call chronic form. Once it becomes chronic form you can only manage it and never get rid of it (or so they say). So many people with MAC also have Pseudo. I also wonder about why those seem to go together. Thus far my tests for MAC are negative but I do have chronic Pseudo. The only oral options for Pseudo are Cipro or Levo. And inhaled usually to just "manage" it, Toby or Cayston or used along with other antibiotics. And a number of IV options.

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To all who have/had pseudomonas aeruginosa;
when did your doctor decide to start treating this bacterium- were you told to start right away because there is a better chance to get rid of it or if you did not have symptoms (and what symptoms) to wait. I was diagnosed with it last September and my doctor decided to not treat it (no symptoms), I had my RESP culture two weeks ago, I still have "moderate pseudomonas aeruginosa" and my doctor asks me if I think she should treat it. (she says CIPRO) I think I cough more and have some more clear mucus in the morning but otherwise nothing different. How can I know if it should be treated? She says its up to the patients, how they feel and the initial treatment might or might not work. I am also on Azithro and Clofazimine for MAC. Thank you for your thoughts on this.

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@lilianna

To all who have/had pseudomonas aeruginosa;
when did your doctor decide to start treating this bacterium- were you told to start right away because there is a better chance to get rid of it or if you did not have symptoms (and what symptoms) to wait. I was diagnosed with it last September and my doctor decided to not treat it (no symptoms), I had my RESP culture two weeks ago, I still have "moderate pseudomonas aeruginosa" and my doctor asks me if I think she should treat it. (she says CIPRO) I think I cough more and have some more clear mucus in the morning but otherwise nothing different. How can I know if it should be treated? She says its up to the patients, how they feel and the initial treatment might or might not work. I am also on Azithro and Clofazimine for MAC. Thank you for your thoughts on this.

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I think we're going to the doctor to get their professional, experienced opinion. How are you supposed to know if you should be treated or not? Nowadays some doctors don't want to take a stand thinking of the legal ramifications. What a sorry state of our medical system.

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