Tobramycin - 2 weeks virsus 28 days

Posted by fdixon63 @fdixon63, Jun 25, 2022

Hello all. I have a phone appt with my pulmonary doc on Tuesday and he will start me on Tobramycin for pseudomonas. I also tested positive for MAC but no treatment recommended for that. He said I could do 2 weeks or 28 days. I been on Tobi 3 times over the last three years with my previous pulm. doc in Atlanta–I switched to one in B'ham because of the distance. The previous treatments were always 28 days. The information on Tobi only says do treatment for 28 days. Has anyone out there had success with only two weeks of treatment? Thanks.

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My treatment was for 2 weeks because I couldn't tolerate longer, then 2 weeks off and another 2 weeks on. It cleared everything up, and that was 4 years ago.

I am wondering if this might be a newer protocol? Every antibiotic we have been prescribed over the past 18 months was for a shorter time than we had previously used. Sometimes it worked, sometimes it led to another course a week or two later. My daughters, both nurses, say they are seeing more of this.

What did the new pulmonologist say about the shorter term?
Sue

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@sueinmn

My treatment was for 2 weeks because I couldn't tolerate longer, then 2 weeks off and another 2 weeks on. It cleared everything up, and that was 4 years ago.

I am wondering if this might be a newer protocol? Every antibiotic we have been prescribed over the past 18 months was for a shorter time than we had previously used. Sometimes it worked, sometimes it led to another course a week or two later. My daughters, both nurses, say they are seeing more of this.

What did the new pulmonologist say about the shorter term?
Sue

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Good Morning Sue. So glad you got back to me before my phone appt. with my pulmonary doc today at 10AM. I remembered you had quite a battle with Pseudomonas–me too. Your message is clear wisdom with what the doc said to me on my initial visit with him a year ago–I was a referral from another pulmonary doc, who was excellent but he did put me on 28 days Tobi three times in three years. It is a tough treatment for me, even having to go the the ER with ??bronchial spasm. I think this time a two weeks on and two off and another two weeks should be a better treatment plan for me this time. I agree that more doctors are doing more wait and see for antibiotic use. I did get increase my airway clearance to 3 X a day rather than two. He ordered the 3.5 Hypersal which I may continue to use during Tobi treatment but will go back to 7%.
Appreciate you so much. I'll let you know what he says.

REPLY
@fdixon63

Good Morning Sue. So glad you got back to me before my phone appt. with my pulmonary doc today at 10AM. I remembered you had quite a battle with Pseudomonas–me too. Your message is clear wisdom with what the doc said to me on my initial visit with him a year ago–I was a referral from another pulmonary doc, who was excellent but he did put me on 28 days Tobi three times in three years. It is a tough treatment for me, even having to go the the ER with ??bronchial spasm. I think this time a two weeks on and two off and another two weeks should be a better treatment plan for me this time. I agree that more doctors are doing more wait and see for antibiotic use. I did get increase my airway clearance to 3 X a day rather than two. He ordered the 3.5 Hypersal which I may continue to use during Tobi treatment but will go back to 7%.
Appreciate you so much. I'll let you know what he says.

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Did your doctor also order an oral antibiotic when doing Tobi??

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@fdixon63

Did your doctor also order an oral antibiotic when doing Tobi??

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Yes, I was using Cipro at one point, and Levaquin at another. But finally, it was just the Tobi.
Sue

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Sue. I did do the phone appt today with my Pulmon. doc. The plan is to do the 2 weeks on 2 weeks off of Tobi and then gauge how effective it is. No oral antibiotics will be ordered for now. He said his goal is to get me only having to do airway treatments once a day. (now doing 3X a day) I said that would be like a vacation. Take care Sue and thanks again.

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I have battled pseudomonas for over 10 years. It is now the mucoid strain. I tried inhaled Tobramycin about 6 years ago but couldn't tolerate it. When I was at NJH in April, Dr. Griffith recommended I try 2 weeks on/off to prevent my frequent exacerbations. So far, it's working great! I haven't lost my voice, my cough is greatly reduced, and my sputum samples say "few pseudomonas aeriginosa"! Dr. Griffith said we'd try it for 6-12 months. I hope you get good results as well!

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