Bronchiectasis.. Should you stop talking Azithromycin if you have to start Ciprofloxacin?

[Phill1]

Hi Bronchiectasis friends

I Have colonized pseudomonas.. diagnosed last October .. feel ok but this week I’m not sure if I’m having a flare up . My only change is that I’m producing more mucus & I can feel it sometimes in the center of my chest.

May have to start my ciprofloxacin rescue pack ..😖

If / when I do should I continue with my Azithromycin 3x weekly 500 mgs??

[Hidden]

Hi Phill. I can no longer take cipro but have always been told, when on any other antibiotics, to drop the azithromycin, and resume when the course is finished.

Just as a thought, from someone who’s been colonised many years, I’m not sure I’d start the cipro yet. If there’s a marked increase in sputum volume and congestion (and particularly a change in colour and viscosity), then yes, but if you take cipro too often you risk developing an intolerance. You’d then be stuck with needing IV antibiotics every time you have a flare up, which is a great nuisance. You know your own chest of course! Do you also nebulise antibiotics to suppress the pseudo?

[Phill1 in reply to Hidden]

Hi Hanne62.. Thanks..& thankfully didn’t start the ciproThink It was a more acid reflux that I was feeling.. settled now but is now another new thing to contend with🙄.. not sure I should do postural drainage

I don’t nebulise .. only diagnosed with pseudo last Oct.. may be something to talk to Consultant about at next appt ?

[Hidden in reply to Phill1]

Hi again! If you have reflux, avoid being tilted. I do my airway clearance lying on my side on the sofa (15 mins each) with my head on two cushions. As long as it’s about 2hrs since I ate, that doesn’t affect my reflux and I can still clear my chest.

If pseudo has colonised your lungs, nebulised colomycin is fairly standard. Otherwise you’d be on cipro nearly all the time. This happened to me, and too much cipro gave me tendinitis so I can no longer take it at all. Now I’m on colomycin it doesn’t flare up often, but when it does, I have to have IVs, which is a blasted nuisance. I wish I’d had colomycin sooner, then I could’ve kept cipro in reserve. So yes, good idea to mention it to your consultant

[Phill1 in reply to Hidden]

Hi Hanne Thanks for reply.. I’m impressed that you only do 15 mins each side.. seems to take me an hour .. plus more sometimes (tiring)..

on my back and both sides.. are you doing autogenic drainage or ACBT? and how many times a day?.. just wondering if I’m doing it right?..

Only had cipro once last November.. hoping it stays that way 🤞x

[Hidden in reply to Phill1]

Ha, well, I actually timed myself today, and although I’m supposed to do 15mins, cos more tends to inflame asthmatic airways, it was actually 25! But even then my lungs weren’t clear. I only do that in the evening tho, in the morning I spend 15-20mins altogether and I do it sitting up (the reason is, I just can’t be arsed!)

I do AD, I don’t find just ACBT works for me, I have to really coax the stuff up. I use 7% saline, and take NAC too, but my lung secretions are still very viscous & hard to shift. It’s very boring, and very tiring as you say.

I hope you’re lucky with the cipro! It did work for me for quite a few years, at the start, so 🤞🤞🤞

[Phill1 in reply to Hidden]

Thanks for reply I do AD… Had a better day bringing it up today.. just wish it was like that every time🙄.. It does take a lot of coaxing .. has NAC made a difference?Also asked my consultant if I could cut down the azith to 250mgsx3 per week instead of 500 mgs as it drains me (as well as occasional upset stomach).. fingers crossed (again😅)

BE is like a poker .. chancing quality of life vs fighting the pseud ..!🤞

[Hidden in reply to Phill1]

I’ve been on NAC 6wks but can’t say it’s made any difference tbh. I’ve tried carbocisteine too, ditto. However some people get on well with one or the other.

I only take 250mg azith x 3 weekly. I’ve got hearing problems & tinnitus & the higher dose can make it worse.

Airway clearance is a daily battle & the success or otherwise hugely impacts what I can do. I find exercise is the best thing, but I can’t walk outdoors in winter so I use a treadmill. Not as good but better than nothing

[Hidden]

Hello Phill1. I took azith for 5 years. Whenever I took cipro I stopped the azith during that time.

[Phill1 in reply to Hidden]

Thanks Lp.. didn’t start them in the end thankfully . Think was probably acid reflux.. settling but another new ailment to contend with😳

[HollyBoyd]

Hi Phill. Like you I am colonised with pseudomonas and take Azith 3 times a week. I was told by consultant to stop Azith if starting a course of antibiotics for a flare up. Hope you get the pseudo under control, good luck xxx

[Phill1 in reply to HollyBoyd]

Thankfully didn’t start them but useful info.. for when I do.. thanks!

[B0xermad]

Hi phill1 I always can Continue with azithromycin on antibiotics(amoxicillin)even with pneumonia and pleurisy during a bronchiectasis flare up but only grow haemophillis influenzae bugs not pseudonomas so not sure if that helps or you or not, best wishes to you.

[davannh]

I have recently been on both Ciprofloxacin & Azithromycin my Consultant did not consider it an issue to take them together.

[Phill1 in reply to davannh]

Thanks .. useful information 👍

[Maximonkey]

Hi Phil, no, stop the Azith when you take other antibiotics. Resume after the course is finished. Take care and get well soon. Maximonkey

[Phill1 in reply to Maximonkey]

Thanks.. didn’t need to start ciprofloxacin thank goodness but know what to do now when I have to 👍

[mollie2shoes]

I stop all other drugs when taking cipro, been advised by Dr's many times to do this as they don't always like each other in your system. Hope you get better very soon, I've been there countless times... its a horrid disease to have, always firefighting it. Good Luck. Mollie

[Phill1 in reply to mollie2shoes]

It is horrid isn’t it.. and so tiring having to do lung clearance.. luckily didn’t have to start cipro .. but agree with your advice .. thanks!

[Phill1]

Thank you everyone for your such helpful repliesI thankfully haven’t had to take the cipro as yet but will go with the majority and stop the azith when the time comes

The down side is I think It is acid reflux causing me problems in the centre of my chest😳

And now worried about how to do my mucus clearance because the easiest way for me was postural autogenic drainage 🙄

[Phill1]

PS.. any tips for managing acid reflux / mucus clearance would be much appreciated ! x

[Biofreak in reply to Phill1]

Do you take omeprazole to control the acid reflux? My GP prescribed one a day before breakfast because all the tablets I have to take cause were causing acid reflux and reflux can complicate lung conditions if not controlled. If you don't already take them have a word with your GP.

[Phill1 in reply to Biofreak]

Thanks for the info👍..It seems to have settled 🤞 but actually have a telephone appt with GP next week so will mention it

[Superzob]

There is no known interaction between the two (bnf.nice.org.uk/interaction..., but I would check with your GP

[Phill1 in reply to Superzob]

Thanks …that’s reassuring

[Redrum46]

Keep your chin up as thy say you will get thir iv been the same good job we have a specialist chest consultant

[Phill1 in reply to Redrum46]

Yes.. So many ups and downs with BE Very grateful that we have easy access to experts..