rotation of Bactrim & doxycycline. Gut is torn up. Help!

Oh my, that seems a lot to deal with. Would it be possible to say more about your diagnosis in terms of what these antibiotics are treating? Has your sputum culture grown something specific? How is your air clearance routine going? How well versed is your pulmonologist in treating bronchiectasis? Any other pertinent details you can provide might yield advice for you from this supportive group.

@juliawb Did you ever find a new pulmonologist? I cannot find any current protocol that uses these 2 drugs to treat Bronchiectasis, so I assume they are treating an infection. If so, do you know what it is?

Years ago, it was pretty standard to alternate 14 or 28 days on then off a drug like azithromycin to try to prevent infections, but as you have learned the side effects can be difficult to manage. In addition, overuse of the drugs has lead to greater antibiotic resistance. The gold standard now is daily airway clearance plus monitoring. You might find this document very helpful:
https://www.ntminfo.org/wp-content/uploads/2019/09/Guide-for-Patients-with-NTM-Infections-2019-09.pdf
Do you do airway clearance? Do you have regular sputum cultures to see if you have an infection?

I was on antibiotics most of last year.
I discovered something available on Amazon called Banatrol
It is a miracle. After years and years of IBS and diarrhea, even after a single antibiotic, I never have a problem.
I mixed a couple of spoons and with water and milk sometimes and drink a few ounces before and after taking my antibiotic. Seems to protect my stomach completely. Hope this helps

I have MAI not MAC. THANKFUL for that. I’m still at Duke AAA clinic.

And yes, I do airway clearance with pep fluttered. My case is mild and there has been improvement. Sputum cultures are done.

I have a mild case of bronchiectasis and sputum culture has shown MAI.
August 2023, I was diagnosed with mold induced hypersensitive pneumonitis. It was treated with several months of prednisone. Lungs responded well and pneumonitis is resolved. February 2024, I had Nocardiosis (nocardia bloomed in sputum culture) . Double dose of Sulfamethoxazole/trimethoprim for two months knocked it down. Sputum culture in July/August 2024 revealed MAI and thus the rotation of Sulfamethoxazole/trimethoprim and doxycycline. I use a a PEP flutter for airway clearance. Breztri for asthma.
I am actually doing really well save for the gut issues .
I am treated by Dr. Yuh-Chin Huang and he is well known for treating these issues.
Is this the information that might be helpful?

My last culture shows Nocardia too. My doctor is not treating it yet but I'm scared. May I know when you say double dose, does it mean Bactrim DS (800Mg) twice a day? As for MAI, what is your dose for Bactrim and Doxy?

Yes, that is correct.
One twice a day is dosing for MAI.
Hope all goes well for you.

Let's clarify please, when you say MAI do you mean Mycobacteria Avium Intracellulare? If so, the is part of the infective group known as MAC (Mycobacteria Avium Complex) or NTM (Nontubercular Mycobacteria.)
Are your culture still positive after 10 months on your drug regimen? If so, have the sputum samples been submitted for drug sensitivity testing to be sure you are using the correct antibiotics to actually clear the infection?
What sort of improvement are you seeing? Improved CT, less cough, clean culture, etc.

Please excuse my curiosity, but in seven years on Mayo Connect and NTM-ir, I have never seen this particular combination of meds used.

Goodness, I feel like I am doing all of this wrong. I have had improved Health; improvement has been seen on CT scan. I will see my pulmonologist in three weeks and I imagine sputum cultures will be taken. So, what is the gold standard treatment in your opinion?