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Pseudomonas. Can steroids help to eradicate pseudomonas?

Lfcpremier profile image
26 Replies

Following a nasty virus at Xmas still struggling with excessive mucus & wheezinessConsultant suggested prednisone might help when nothing showing up in sputum sample but most recent one revealed a small amount of pseudomonas.

Would steroids help please?

Linda

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Lfcpremier
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26 Replies
TomTitTot profile image
TomTitTot

Lfcpremier,

Steroids are very useful when inflammation is suspected. They can however, sometimes mask an infection. They are often prescribed along with antibiotics, but they will not clear an infection. They will help to open up your airways to make breathing easier.

Do follow through on sputum identification to make sure that you have the proper antibiotics.

Best, hope you feel better soon.

Anne

Lfcpremier profile image
Lfcpremier in reply to TomTitTot

Thanks Anne. I think that I am colonised with pseudomonas but it comes & goes. Usually under control but not since this virus at Xmas.

PaulineHM profile image
PaulineHM in reply to TomTitTot

Sorry to read that you are still full of mucous, wheezy and that Pseudomonas has announced itself.

A short course of steroids will likely help to reduce the mucous production and decrease the wheeze, but not sure that it will impact the Pseudomonas. A respiratory physio can often help to with methods to shift excessive mucous.

Could have a consult with your surgery pharmacist about a treatment programme ? I find these pharmacists really fantastic and value their expertise, skills and knowledge.

Hoping you can find some relief soon.

Good wishes.

Lfcpremier profile image
Lfcpremier in reply to PaulineHM

Thank you. I do a lot of lung clearance & nebulisd 7%saline 2x a day.

bridgeit profile image
bridgeit

Hi Lfcpremier,

a friend of mine has chronic pseudomonas infection alongside bronchiectasis. I can share with you what she has told me in conversation, but cannot speak from personal experience or medical training (I have none).

She prefers to avoid steroids where possible but does take some heavy-duty antibiotics that she's prescribed from time to time when the pseudomonas infection is raging, to bring it under control.

I think pseudomonas eradication, in her case, has been stated unlikely by her specialists, but it is the antibiotics that are the prescribed control agent for this particular bacterial infection, not the steroids.

I hope that info is helpful.

Lfcpremier profile image
Lfcpremier

Thank you bridgeit. I do have ciprofloxacin at home but had such a bad reaction from them last time it puts me off taking them.It really is difficult knowing the best course of action, such a tricky bug.

PAP48 profile image
PAP48

Hi Lfcpremier - I’m colonised with pseudomonas (bronchiectasis) and my treatment is Azithromycin antibiotic taken 3 days a week always to keep the levels down and during exacerbations nebulised Colomycin antibiotic taken for 6 months or more. I only take steroids if my asthma gets too bad which thankfully is fairly rare. My consultant is wary of me taking too many generic antibiotics as the body can become immune to them. Stay safe and well.

Lfcpremier profile image
Lfcpremier in reply to PAP48

Thanks Pap48.. I take azithromycin too. The pseudomonas seems to come & go & I avoid antibis as I don't tolerate them well. Colomycin has been mentioned & I suppose I'm being monitored for it.

cat50 profile image
cat50

Hi Lfcpremier

I have Bronchiectasis with colonised Pseudomonas .I can’t take Ciprofloxacin either..I have to have IV antibiotics .I have nebulised Colomycin that can keep the pseudomonas suppressed .You need to inform your Consultant that you have problems with Ciprofloxacin.Keep taking a sputum sample .

Lfcpremier profile image
Lfcpremier in reply to cat50

Thanks Cat50.

oh dear, every time I see a post about bronchiectasis, the ongoing confusion and misinformation amongst doctors and patients about this complex condition become ever more painfully clear.

In answer to your question. Oral steroids are not recommended for bronchiectasis unless the patient also has asthma or emphysema. This can be found easily in the British Thoracic Society’s guidelines for bronch.

I have had bronch for 68 years, have been colonised with pseudomonas since 1986 and have never had oral steroids.

The only oral drug which truly affects pseudo is ciproxen. Sometimes doxycycline can help but is not as affective. Azithromycin fights inflammation and is therefore useful at keeping down the numbers but is not in itself an agent against pseudo. It helped me for five years then I had to stop it because I was taking digoxin for heart failure.

If you can’t take cipro and pseudo is making you poorly, the only option should be IV antibiotics to get the numbers down followed by long term nebulised antibiotics to keep them down to a level where you can have an active life.

Together with scrupulous daily emptying of the lungs of course.

Your consultant does not seem to know this and is treating you as though you have copd. Many general respiratory consultants do this. They do not have enough training or experience of bronch and GPs mostly know nothing about it. You need to check whether your consultant is a bronch specialist. If not, you need to change. Find a bronch specialist at your nearest big teaching hospital, take the name to your GP and insist on a referral.

There is a preoccupation amongst patients with obtaining lab tests to find out what bug is in there. This may work well for copd but is next to useless for bronch. So many times results come back as no bacteria present when we are obviously unwell. Pseudomonas hides, it takes a long time to grow and plates become corrupted. Most bronchs know which bug tends to love their lungs after their first appointment and tests with a bronch specialist. Their GP should be instructed by the specialist to give them the right rescue antibiotic to keep at home. Specialists are also able to source IV and nebulised antibiotics plus make proper checks to find out if the bacteria has changed or if aspergilla fungus has established itself. When we have run out of oral antibiotics and are unwell the first port of call should be their secretary.

I hope that you found that helpful

Lfcpremier profile image
Lfcpremier in reply to

Thanks Littlepom. My consultant is very specialised in Bronchiectasis. He knows I'm very reluctant to take antibiotics as I find them hard to tolerate. Don't know if having azithromycin for 12 yrs has made me more resistant to them.Pseudomonas has been around my lungs for several yrs. I did take ciprofloxacin but a lot of side effects. Usually it lies low & Tbh I don't feel particularly unwell:it's just the wheezing & excessive mucous drives me mad.

Thank you for the info though. Find it very helpful.

in reply to Lfcpremier

I wonder if your consultant should look at aspergilla. If you don't have asthma, the wheeziness could be down to that. If the pseudomonas isn't bothering you, your excess mucus and wheeziness must be caused by something else. Therefore it isn't an eradication of pseudomonas that you are looking for.

Lfcpremier profile image
Lfcpremier in reply to

Thanks:will mention aspergilla when I next see him.

in reply to Lfcpremier

My only other thought, and you might not like this. Is that the fact of life with bronch is that much as we all hate it, we are forced to accept antibiotic treatment to stop bacteria from making us really ill and if left to run riot in our lungs, getting into our blood stream and poisoning us. The only symptom that I had of my last pseudo flare up in Jan was increased mucus and cipro knocked it on the head. Given that you say your consultant is a bronch specialist I am surprised that given your refusal to take abs, he hasn't.offered you I V. I think that a discussion with him about all possibilities is on the cards. You shouldn't be struggling like this.

Lfcpremier profile image
Lfcpremier in reply to

Last time I saw him.. A month ago.. My breathing tests were quite good & he said many, like me, were experiencing really bad inflammation after viruses, this year.If antibis worked & didn't make me so Ill I would readily take them. In fact I have a course of cipro here. However, the muscle pain was so severe last time, 2yrs ago I would only try as a last resort.And the pseudo was still there afterwards.

I suppose colomycin or iv antibis would be next.

in reply to Lfcpremier

Yes I guess that they should be. My exacerbation in Jan followed a nasty virus over Christmas which also left me with swollen legs due to the inflammation affecting my cardiomyopathy. I am lucky as I could tolerate the cipro. I hope that you get it sorted.

Lfcpremier profile image
Lfcpremier in reply to

Thank you. 🤞

Heaven20 profile image
Heaven20

Hi all, I haven't posted for a while but I've been a bit concerned after being prescribed ciprofloxacin for the first time. I went partially deaf in one ear (I do have Tinnitus) and my eye was slightly swollen, respiratory nurse told me to stop taking them. I'm going to send another sample next week and hoping it's cleared.My question is what would be prescribed to me if pseudomonas was still there?

My rescue pack has always been amoxiclav but know that will not clear it.

Lfcpremier profile image
Lfcpremier in reply to Heaven20

You have hit the nail on the head. Options so limited for pseudomonas:iv antibiotics or inhaled colomycin.Are you on azithromycin 3x weekly?

I've been told pseudomonas is something that comes & goes & if its not causing me to feel unwell I should learn to live with it as its so hard to eradicate. Good luck!

Heaven20 profile image
Heaven20 in reply to Lfcpremier

No not taking azithromycin, but on my last visit to respiratory clinic we discussed it as a possibility.This is the first time with pseudomonas so didn't know what to expect.

Since stopping the ciprofloxacin last week after 5 days I felt OK, but I think it might be coming back.

Collienut profile image
Collienut

Hi, I'm colonised with pseudomonas and have bronchiectasis and asthma.

Before I became colonised I would routinely be given antibiotics and steroids. Since diagnosed as colonised with pseudomonas, I've never been given steroids, I assumed it was because steroids can make infections worse.

Lfcpremier profile image
Lfcpremier in reply to Collienut

Thanks. I wonder that too.

Patk1 profile image
Patk1 in reply to Collienut

Steroids can mask infection

Patk1 profile image
Patk1

If theyve suggested trying them,yes they could help.inflammation can cause wheezing+ steroids may settle it x

Lfcpremier profile image
Lfcpremier in reply to Patk1

Thanks. 👍

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