British Lung Foundation
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Hello everyone, Just getting over a chest infection so have been out of touch for a while. It's good to be back and I'm looking forward to catching up with all of your posts.

Being unwell I have had time to ponder over something that has been on my mind for a while. It will, no doubt be a question many of with bronchiectasis will be able to answer. Why is it that some of us have nebulized antibiotics and others take oral medication? I understand that nebulized antibiotics go directly into the lungs to work on the bacteria and pseudos that are there. So it seems reasonable to me that all sufferers should benefit by having the quickest method available to them. Isn't the nebulized method the quickest way of eliminating the bacteria? I would be grateful for any information as I have been pondering over this for the past week.

38 Replies

Just want to say glad you’re feeling better and good to have you back. Xxxxx

Oh, thanks for those kind and caring few words sassy. So appreciated as have I felt pretty miserable over the past 10 days. Hope the weather will start improving to lift all our spirits.

Hi RoadRunner44

There are a lot of us who nebulise various different antibiotics as a prophylactic to keep the bugs down particularly pseudomonas. This has to be arranged by the hospitsl consultant. When that is done, some GPs can supply such as colomycin but I nebulise cephtazidime and the hospital supplies it. Sometimes the bugs have a party and it is then necessary to have s course of oral antibiotics or maybe IV to knock it on the head. Some people cannot tolerate nebulised antibiotics and also most oral antibiotics. Some people take azithromycin 3 times each week long term which is good at keeping inflammation down but not very effective against pseudomonasThis is why it is important to have a good bronchiectasis specialist because only they have the training and exoerience in what is a complex condition

You are so right about the right specialist. I am attending a pulmonary rehab. 6 week course which includes exercises and education about bronchiectasis. Over the past year I have learnt a lot about my condition. It's strange, and I really appreciate the team's input, andthere Im learning things each time I go. However, they follow guidelines given to them and after being a member of this forum it is very obvious to me now that our members are probably more knowledgeable and information given isn't always correct. It's a bit frightening but as I've said before, we have to be more responsible and empower ourselves by acquiring as much information we can to help ourselves to help our doctors and specialists.

Thanks for replying to my post and for the useful information I almost expected to receive from you. Cheers for now. Take care and keep warm.

Well done you. PR is brilliant I am told. I had the equivalent of 8 years of it as a child because I was lucky enough to bump into a radical consultant whom the medical prof thought was barmy. All of the treatment he gave me is standard now and I am sure that he gave me a better quality of life.There is no substitute for experience and learning all you can. At my age most of the medics are catching up with me! We will get them there eventually ☺️

Great reply from Littlepom. Prophylactic medications are given for different reasons than is antibiotic for treatment purposes. That is propylactic medication is given to dampen down pseudo to a low level. Nebulised antibiotics are given in high doses as they are delivered directly to the lungs as you say in your post but they are not used as a treatment. Azithromycin and few other medications (oral) are also used prophylactically and are given in smaller doses than that for treatment.

IVs are the quickest way to deliver antibiotics.

I am one of the ones LP mentions who cannot tolerate prophylactic medications and therefore have IVs. I have a permanent midline in which I have to flush every day and have to visit the hospital once a week. I am though waiting for a port to be fitted.

Love cx

Thanks for your reply. It contains more information to file away in my bronchiectasis file. There is so much to learn about such a complicated lung disease as this is. Interestingly, today at the pulmonary rehab. Course I'm attending nearly all the attendees thought that bronchiectasis was the same as COPD. Quite amazing and demonstrates a real need for education. Take care.

Glad you are getting over your chest infection, & this is a really interesting question, which I would love to know the answer to myself. But I think the answer will be , it varies for each one of us , Taking a pill is the easiest for us, nebulising takes longer & is time consuming & you have to keep the nebulser etc clean. But if it is more efficient & perhaps overcomes the problem of becoming immune to AB's better than pills , then worth doing

They are trialing some hopeful new nebulised drugs, but mostly they will be too late for me, but will help younger Bronch's

I am allegedly going to be on one of the trials, but before I can start I have to come off my Azithromycin & all AB's for a month & haven't managed to do that yet as I keep getting infections

Love to you all Sohara

in reply to Sohara

I was wondering how you were doing re this trial.

Love cx

in reply to cofdrop-UK

I haven't been able to start it yet, as I haven't been able to go a whole month without any AB's , it seems a bit dangerous for me to give up my azi during all this bad weather & sneezes around everywhere I hope they will let me wait until the spring until I have to stop my azi for a month

I will keep you updated

in reply to Sohara

You must do what you feel is best for you sweetheart. It’s a lot to contemplate. I would think they will have to wait for quite a few folks in the UK until winter is over.

You know I just want what’s best for you.

Love cx

in reply to Sohara

This is su ch exciting news that you are going to be part of a trial. I do hope you will keep us informed as to how it goes. I also hope you will be well enough to participate on it as its people like you who are prepared to take part in these trials that will benefit others in the future.

I wish I could say something more positive to make you feel better. Thank you for taking the time to reply to something that has been bothering me for some time. Take care and keep warm. Xxx

Hi Roadrunner44 I am also one that Littlepom mentioned. I can't tolerate nebulizer antibiotics colomycin. I am fine with ciprofloxacin for now so I have treatment with ciprofloxacin then I must change to hospital IV. Then so long with ciprofloxacin when I have infection.This is my treatment for pseudo. This is all I can do until their is a new treatment that will suit me. Majt x

in reply to Majt

Oh thanks for your reply and simple explanation. I assume then that its not the method of nebulizing antibiotics that you can't tolerate but the colomycin itself which is only available to use via a ñebulizer. Is that right?

Colomycin can be given by IV but not orally.

More information to store away Littlepom. You really are a mine of information.

Sadly I have been on this roundabout for a very very long time.☺️

Yes that's right the drug colomycin Unfortunately.

I wondered where you'd been. I hope you're starting to feel better now 💐

Hi. HH, It's good to be back and thanks for posting.

I have almost boasted about how well I have been over the past months but was pulled back, so to speak when a little cold turned out to be a chest infection. As I'm not having any treatment at all now ( for the bronchiectasis) I'm wondering if its because of this that I developed the infection. I have just one month to go after stopping the colomycin to see if it is that which is causing the neuropathy I continue to experience. I can't help wondering what the next step will be. When I see the consultant next will I be put on a different antibiotic. It's all a bit of a minefield but we have to try and find a way through it all.

How are things with you by the way? I'm still trying to catch up on members to see how everyone is. All for no, Take care and keep warm. Xx

Bits of me are fine 😊

Perfect answer!


Just started taking Voriconazole and having lots of side effects- I would say on the verge of hallucinations! I was given this because Itraconazole was no longer effective. After reading your posts, I was wondering if taking antibiotics through a nebuliser would have been a better line of treatment.

I’m also very interested in hearing about your trial Sohara.

Many thanks for your posts.


Voriconazole and itraconazole are anti fungal drugs, not antibiotics. They are usually given for aspergillus. I have so far avoided this problem but a physiologist at the QE in Bham told me that they give these antifungals by nebuliser. It may be worth you asking your consultant about it.

Thanks for your reply. I should have been clearer in my post- I just wondered if changing my antibiotics(to inhaled not oral) and not my antifungal drugs would have been a better approach.

Thanks for your input

If nebulised antibiitics would help keep the numbers of your bacteria in your lungs down it may be a good idea. Of course you will still need antifungals if you have aspergilla. It is really worth talking to your consultant about it all.


Good to have you back road runner xx hope you're much nbetter

Hello, and thank you for your warm welcome back to the fold. Things are getting easier, thank you and I'm enjoying catching up with members and hope everyone is managing in this atrocious weather. Hope you too are well. Keep warm and safe. X

I’m pleased you are starting to feel better and hope that continues. I have nebulised colomycin for pseudomonas as the cipro stopped working for me. I had a two week course of ivs to kill the pseudomonas and have used the nebuliser twice a day since. Both colomycin and gentamicin are old fashioned antibiotics with nasty side effects as some on here have mentioned. I also take co-trimixacole and was taking Azithromycin until recently. I think the docs like to keep the heavy duty stuff until all else fails.

Good to see you back on the site Roadrunner and glad that you are feeling better x

in reply to Izb1

Thank you, Your kind words make me feel better than ever.

Welcome back and hope you're back to full health soon.

I hope the same for you too Dedalus. Nice to hear from you.

Hello RoadRunner44, glad you're feeling better. I started taking Azithromycin 500mg 3 times weekly for frequent lung infections in 2017. Last year I was diagnosed with pseudomonas and mild bronchiectasis. Since I live in the US some of the medications will be different. I am now given Cefepime through iv and Cayston is nebulized, but with a special nebulizer. My pseudomonas are resistant to Ciprofloxacin and I can't tolerate Tobramycin, it's a nebulized medication. Everything is so unique to each individual.

grannyk 🍃

Yes, your right, It is not clear cut at all. In fact it can be quite confusing. It looks more and more like trial and error. Unfortunately we are the guinea pigs.

I should have probably added that the pseudomonas aeruginosa and bronchiectasis are in addition to end stage emphysema- diagnosed in 2002. After finding the right combination of drugs I really did feel better so there's hope.

You have a lot to deal with but I sense you are a positive person. Chrys

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