July 27, 2021 at 2:26 pm #17222WilliamParticipant
Over the last year, I’ve been growing cultures which, is normal for CF, but at the same time, it’s the same infection coming back. Obviously the antibiotic isn’t totally working. What do you do if that’s the case?
July 28, 2021 at 4:14 am #17224Paul met DebbieParticipant
There are several option to discuss with your doctor.
– take longer courses (3 week minimum)
– take the antibiotic continuously
– try another antibiotic for which the culture is succeptible
– try a combination of antibiotics
– try antibiotic in higher doses or per IV
– try combining with nebulized antibiotics
– combine antibiotics with medication to control inflammation, for instance prednisone or nsaids.
Cultures are not always conclusive. The bacteria that come up may not always be the one that causes your complaints. Or reversely, the bacteria that actually causes the trouble, may not show up in the culture (especially with anaerobic bacteria this is often the case) . They might have to do a bloodculture as well. Or a pcr test. There also may be some fungal cause of inflammation.
Also really sterilize your nebulizer every day, you might otherwise re-colonize from that source. And desinfect your hands before touching the nebulizer.
For the rest, sometimes this is what happens with CF. Infections respond well to antibiotics, but go dormant only to return after a couple of weeks after stopping the medication. Bacteria can hide in microfilms. If you have to go on continuous antibiotics, nebulizing them is the preferred method. But you might still need oral or IV courses as well.
July 28, 2021 at 5:36 am #17225Paul met DebbieParticipant
Oh, I almost forgot to mention two things that are not on the frontpage of our awareness, but should be:
1. Make sure your dental care is in order. The teeth can harbor many bacteria, also anaerobic ones, that can also colonize your airways. The nebulizing can be a perfect transport mechanism for this to happen. Always brush your teeth before nebulizing and don’t eat/drink while nebulizing (only water).
2. You might consider lowering or stopping meat consumption. Modern bio-industry produces meat by putting high doses of antibiotics and growhormones into the animals, that also turn up in their meat and, by eating, in our bodies. Over time, this can reduce the susceptibility of our bodies to entire groups of antibiotics and compromise our immune system.
July 28, 2021 at 2:00 pm #17230Jenny LivingstonKeymaster
Hi, William. You’ve gotten some great responses here, but I also wanted to share some of my experiences. I have cultured the same strains of bacteria for a decade or more. They have never been eradicated. I respond well to antibiotics, meaning that I am able to regain lung function lost during an exacerbation and feel much better after a course of IVs, but the bacteria strains I fight are still there. For me, the best we’ve been able to do is suppress the infection when it flares. This may not be very encouraging to hear, but I’ve found peace in knowing that while I may never be rid of infection entirely, I know that we can treat symptoms in and manage life with colonized bacteria.
July 28, 2021 at 7:44 pm #17236Tim BlowfieldParticipant
Paul has given you a lot of very good information and reasons why you keep culturing the same bacteria. That the bug is resistant to the A/B used is highly probable. That a sensitivity is done every culture is very important – can give misleading results esp with Pseudomonas but is still very valuable. My wife recently had a number of MC&S done for suspected UTI’s – often being reported a only culturing ‘normal faecal organisms (NGO)’ and never subjected to sensitivity. Most recently another lab cultured Citrobacter fruendii and sensitivity showed it was resistant to the antibiotics previously used. It is commonly found in the environment and in the gut/faeces which is why it was probably dismissed as NGO.
With CF nothing should be dismissed!
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