Pseudomonas..

[Lfcpremier]

Hi.. Got 3 sputum test results showing pseudomonas. Find oral antibiotics difficult to tolerate but Consultant has recommended chloramphenicol. Anyone tried this? If I try ciprofloxacin instead what dose would I need to try & eradicate it? Thank you!

[Hidden]

Unless there’s resistance, or another serious contraindication (some people have serious issues with it) cipro is the oral of choice. The reason for that being it’s the only properly effective oral option against pseudo. Doxycycline has a slight antipseudomonal action, as does chloramphenicol to be fair, but they are not generally prescribed as treatment specific for pseudo: if there’s no known reason not to - like, no known allergy to another fluroquinolone - I’d be jumping straight on the cipro, if only because pseudo is a bugger of a bacteria if it takes hold. As to dose, that’s a medical question that none of us would be qualified to answer, but in many cases, treatment courses of cipro where there are no contraindications or other problems are usually in the ballpark of 500-750mg twice a day.

[Lfcpremier in reply to Hidden]

Thank you. I did take Cipro 6 years ago for pleurisy but only 500g daily but didn’t quite finish the course due to shooting pains in my upper leg. I would prefer to try it again as I find it difficult to tolerate antibiotics.

As I don’t feel unwell, reluctant to ‘ rock the boat’ but think the consultant wants to try & see the pseudo off.

Thanks once again!

[cofdrop-UK]

Like you, I am intolerant to many medications including antibiotics.

Chloramphenicol is a very old drug. I was prescribed it many years ago and it was always very effective. However, suddenly my GP decided we should ‘save it for a rainy day.’ There are known problems with the drug relating to the blood (aplastic anaemia being one of them). I had no side effects but have not been prescribed this ab since.

As Charlie says Cipro is the only oral ab which really hits pseudo where it hurts. Again though if you have had problems with tendons in the past, you might want to try it again but watch out carefully for any signs of tendonitis. I cannot take them for this reason but many people find them beneficial.

Eradication of pseudomonas is something most consultants would have a crack at initially but quite frequently people become colonised with it. This means it can lurk around the lungs minding it’s own business but will come out to party from time to time. If colonised there are options re medication, usually nebulised abs but to attempt eradication I would have thought most cons would consider medication by IVs initially.

Please let us know how you get on.

Love cx

[Lfcpremier in reply to cofdrop-UK]

Thank you!Are you on the Bronchiectasis r us site too?🙂...It causes me real anxiety I’m afraid as I am one of those who looks into things forensically & when there’s no answers find it so depressing.

If I hadn’t bothered to email my consultant I would not be in this dilemma : could have told him at the appt in August.🙄Just had our 1st grandchild so should be enjoying life , not festering!

Anyway, thank you for the info,good to know we’re not alone & so many on here, suffer much more than me. Just take the 1st ciprofloxacin tablet.fingers crossed. Xx

[cofdrop-UK in reply to Lfcpremier]

Yes I am. I think Laurel gave you some good advice. She is very knowledgeable.

We all get concerned about new medication, especially if we have lots of intolerances, so you are not alone. Good luck with the Cipro.

You will enjoy life when you get on an even keel with management and medications, especially with your beautiful new grandchild. Enjoy.

Love cx

[Lfcpremier in reply to cofdrop-UK]

Thanks once again! I see you have had such a lot to contend with..💕 Only started cipro yesterday... stiffness in ankle in early morning so already a dilemma to continue or not. May I ask how you knew you were intolerant to the drug? Xx

[cofdrop-UK in reply to Lfcpremier]

Tendonitis. It was in my ankles too.

[Lfcpremier in reply to cofdrop-UK]

Thank you! X

[Hidden]

Uh-oh, if you’ve already got stiffness I’d stop the cipro & contact your consultant. Achilles tendinitis can be very damaging, I persevered with cipro but ended up unable to walk properly for months & all the quinolones are now banned for me.

I had oral chloramphenicol, no side effects apart from extreme fatigue but it’s a very old drug & you need monitoring as it can cause anaemia. However it made no difference to either the pseudo or the MRSA I was growing at the time!

So I had 3 weeks IVs but ended up colonised anyway & have been on nebulised colomycin ever since, which works a treat most of the time.

Do you have a Hospital@Home service in your area? If so you can just go in to get a midline fitted, have first IV dose & then go home. That’s what I’ve done for last couple of years.

[Lfcpremier in reply to Hidden]

Thanks Hannae62. I have emailed my consultant.. Hoping hell will bring my appt forward. The ankle stiffness has gone for now. Will monitor. Thanks again! X