Antibiotics and pseudomonus - British Lung Foun...

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Antibiotics and pseudomonus

angie26
angie26

I'm having terrible problems with antibiotics. I regularly grow pseudomonos and I have an emergency pack of Clarithromycin of 1 week 500mg. As soon as I take them I begin to feel better and acouple of days after completing the course I'm back to square one. I saw a respiratory Dr. who has suggested long term antibiotics of 2 weeks of Clarithromycin and then two weeks of Amoxacillin, I started the Amoxacillan and became very poorly, I had dreadful pain almost like flu and headache and nausea, so bad I had to get the emergency Dr. in the evening, as I'm allergic to flucoxacillin he was surprised I had been given Amoxacillin. I had 6 months of Jaundice after breast cancer with Flucoxacillen! My own Dr. says that I cannot be allergic to Amoxacillin as Ihave had this several times before and it was probaby the infection that caused me to be ill, so the fact that I stopped the Amoxacillin and the symptoms disappeared is that not a reaction to the drug? I am quite deaf and My respiratory Dr. wants to trial Azithromycin but has requested a Audigram and ECG prior to trialling. I have tried Colomycin and other drugs and can't tolerate. I am now doing the Clarithromycin for 4 weeks and 2 weeks off until I see my respiratory Dr. on 30th December. has anyone been in a similar situation?

19 Replies
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Your story says more about the shortcomings of your GP, however well-intentioned. so no wonder you are confused and anxious. There are any number of contributors to this forum who can give you good advice about the burden of medication, in particular Clarithromycin and Amoxacillin. Can I recommend a booklet: Living With Bronchiectasis. free from both the BLF and from Chest, Heart and Stroke, Scotland? Both pamphlets give you the low-down on Bronx and the medication to be careful of mixing.

Good luck Angie and try to keep calm and cautious about medical opinion. You must always seek a second opinion, and try to get an appointment with a bronx consultant asap

angie26
angie26
in reply to Cateran

Thank you so much I was beginning to thisk I was imagining things!

One week is not generally considered effective in most infections borne by people who have lung issues like bronchiectasis. If you keep coming down with pseudomonas aeruginosa the best treatment seems to be 14 days of multi ABX IV as you are possibly colonised with it. If the 14 days IV ABX does not do the job, long term ABX should be considered. I am on many meds but nebulised Gentamicin is my long term ABX with three days a week Azithromicin, this is a great anti inflammatory and has helped me immensely.

It sounds as though you have lost confidence in your doctor so you should ask for a second opinion at least if not change your doctor. They have a complicated job trying to keep you healthy, this often means a cocktail of medications and treatments and they do sometimes react with each other. I wish you the best in getting yourself sorted. Regards

It is always good to hear whena bronch is getting thorough and appropriate treatment. I hope that yours is keeping you well. Unfortunately Gentamycin is one of the abs that does not work for me when bebulised. 18 years ago it totally stuck my lungs together very scary. Ceftazidime works for me and I now have access to home IVs for when I have to succumb to them. Life IS improving for some of us but we have to encourage those who are struggling with ignorant GPs and terrible treatment to demand better.

I really do not know why any doctor is giving you amoxycillin against pseudomonas. It is as useless as taking smarties. Pseudo can also become resistant to clarithromycin and azithromycin.The only truly effective oral drug against pseudomonas is ciproxen 750mg twice each day for 14 days if you have bronchiectasis and providing you can tolerate it. I suggest that you get back to the consultant, not the GP and get this sorted out.

If you manage to get Cipro and it works, that's good. But be aware that it can sometimes cause tendonitis in some people.

I can't tolerate it my Achilles' tendon was affected and I couldn't walk, I was in hospital at the time and the doc refused to admit it was the cipro honestly Some of these people need a good talking to!

Oh Angie I would urge you to contact your consultant’s secreterary and try to expedite your appointment, explaining your situation, unless this is the doctor who prescribed Amoxil for pseudo. This doctor is one of those who doesn’t know what he doesn’t know and you really need a bronch expert to sort out an effective plan for you. Make sure you have a respiratory consultant with a special interest in cf/bronchiectasis. Amoxil can be effective to treat gram positive bacteria BUT pseudo is a gram negative bacteria (it has a biofilm around it). I would eat my hat if a sputum sample came back from the lab which was sensitive to Amoxil.

When you do see a proactive consultant you can have confidence in your possible allergy/intolerance to penicillin needs to be clarified. Because of your history you will also need to discuss the use of Azithromycin and/or any of the macrolide medications, as one effect can be oto-toxicity.

Hoping you soon get the good treatment you deserve and your new doctor comes up with a plan which is very beneficial to you.

You have to be your own advocate with bronchiectasis (even after a lifetime of it and it’s tedious but necessary).

Cx

Thank you I'm so confused why on earth my consultant is prescribing amoxicillin I don't know and clarithromycin is an macrolide? With 3 weeks on clarithromycin and 2 weeks on amoxicillin , which I had to stop as I was so ill now doc has given me a further 2 weeks of clarithromycin, I feel a dreadful overload!! I would love to find a bronch expert but my doc would need to refer me? and would they just wash their hands of me? Since retiring it's been one thing after another I had breast cancer, TB, 3 spinal fractures due to osteoporosis, so I'm no lightweight!! The drugs they give for TB nearly killed me, I had to stop them and then take them idivually until my body could get used to them, horrific experience!! I will have a look on line for a bronch specialist x thanksgivings

cofdrop-UK
cofdrop-UK
in reply to angie26

You could always let us know of a large city you have access to. Someone may be able to pm you the name of a consultant specialising in bronchiectasis.

Clarithromhycin is a macrolide.

You are entitled to ask for a second opinion in any event.

Cx

Seems like your gp isnt listening, as a bronch we all know that you need 14 days abs and if you have had an allergic reaction to a certain ab then it shouldnt be given again. The girls are right, go back to your consultant x

angie26
angie26
in reply to Izb1

Thank you I will do

I was told the only effective antibiotic for pseudomonas is cipro. Mine became resistant to cipro. I had 2 weeks of iv antibiotics and have nebulised colomycin ever since. I also take azathromycin and co-trimixole 3 times a week. I am immune deficient so this may be overkill for those who aren’t. You need a consultant with expertise in Bronchiectasis your gp clearly doesn’t know and is not seeking any advice. clarithromycin won’t get rid of your infection. Good luck I hope you find someone that can help you soon.

Amoxacillin & Flucloxacillin are both Penicillin hence the similar names so if you are allergic to one giving you another seems negligent So sorry to hear all you have been through & folks are correct you need Specialist & are entitled to see one even if you have to make a bit of a fuss to get the help you deserve. Good luck x

Thank you that was my understand too about the penicllins, but my doctor is adamant that they are different, he is saying they are both penicillins but there make up is entirely different and the fact is I have had it several times previously! I wondered if I thought what I was going through was part and parcel of the infection? but as soon as I stopped the amoxcillen I started to feel better. It was my respiratory consultant who agreed the amoxacillin providing I can tolerate it.

shouty
shouty
in reply to angie26

As Little pom says even Respiratory Drs are not B'ect specialists. But it's very tiring having to fight for your best healthcare at times. Keep going and hope gets sorted soon x

angie26
angie26
in reply to shouty

Thank you

They should be treating you with nebulized drugs not pills..Colistin tobramyacin and cayston are first choice for pseudo...azithromyacin is the big guns med and shouldn't be used yet

Oh dear I'm afraid I'm one of those awkward people, I tried the nebulized drugs and could't tolerate them, this is probably why we're here with pills I'm a lost cause!!!

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