Bactrim if not coughing?

K

kitomd21

New member
A bit of background first...

We met with our daughter's doctor today to discuss whether or not she has fingertip clubbing. She does have a small degree of clubbing (as I suspected) but he wasn't concerned about it until we take a follow-up XRAY. Her fingers have looked this way for as long as I can remember and she's only 2.5 yrs old.

The question about Bactrim is that he has prescribed a round for her. She had a cough a couple of days ago which has subsided and is pretty much resolved. She does have a runny/stuffy nose as does her brother without CF. He listened to her chest and said he heard some "rumbles" and noted a small amount of fluid in one of her ears. My impression is that individuals aren't started on antibiotics unless the cough persists for more than a few days...as her hasn't.

What are your thoughts on starting Bactrim? She hasn't been on antibiotics since less than a year old for an ear infection. I'm concerned about starting antibiotics unnecessarily as she does culture staph and I don't want to use antibiotics until absolutely necessary. Her cough is related to the same cold that her brother had and their symptoms have been pretty consistent with each other except that he had more of cough (and he doesn't have CF!).

Thoughts? Don't go against her doctor's order? I'm wondering if he's thinking the clubbbing warrants antibiotics (i.e., more lung involvement suspected with clubbing) and is trying to address both a cold and possibility of underlying increased lung involvement....
 
K

kitomd21

New member
A bit of background first...

We met with our daughter's doctor today to discuss whether or not she has fingertip clubbing. She does have a small degree of clubbing (as I suspected) but he wasn't concerned about it until we take a follow-up XRAY. Her fingers have looked this way for as long as I can remember and she's only 2.5 yrs old.

The question about Bactrim is that he has prescribed a round for her. She had a cough a couple of days ago which has subsided and is pretty much resolved. She does have a runny/stuffy nose as does her brother without CF. He listened to her chest and said he heard some "rumbles" and noted a small amount of fluid in one of her ears. My impression is that individuals aren't started on antibiotics unless the cough persists for more than a few days...as her hasn't.

What are your thoughts on starting Bactrim? She hasn't been on antibiotics since less than a year old for an ear infection. I'm concerned about starting antibiotics unnecessarily as she does culture staph and I don't want to use antibiotics until absolutely necessary. Her cough is related to the same cold that her brother had and their symptoms have been pretty consistent with each other except that he had more of cough (and he doesn't have CF!).

Thoughts? Don't go against her doctor's order? I'm wondering if he's thinking the clubbbing warrants antibiotics (i.e., more lung involvement suspected with clubbing) and is trying to address both a cold and possibility of underlying increased lung involvement....
 
K

kitomd21

New member
A bit of background first...
<br />
<br />We met with our daughter's doctor today to discuss whether or not she has fingertip clubbing. She does have a small degree of clubbing (as I suspected) but he wasn't concerned about it until we take a follow-up XRAY. Her fingers have looked this way for as long as I can remember and she's only 2.5 yrs old.
<br />
<br />The question about Bactrim is that he has prescribed a round for her. She had a cough a couple of days ago which has subsided and is pretty much resolved. She does have a runny/stuffy nose as does her brother without CF. He listened to her chest and said he heard some "rumbles" and noted a small amount of fluid in one of her ears. My impression is that individuals aren't started on antibiotics unless the cough persists for more than a few days...as her hasn't.
<br />
<br />What are your thoughts on starting Bactrim? She hasn't been on antibiotics since less than a year old for an ear infection. I'm concerned about starting antibiotics unnecessarily as she does culture staph and I don't want to use antibiotics until absolutely necessary. Her cough is related to the same cold that her brother had and their symptoms have been pretty consistent with each other except that he had more of cough (and he doesn't have CF!).
<br />
<br />Thoughts? Don't go against her doctor's order? I'm wondering if he's thinking the clubbbing warrants antibiotics (i.e., more lung involvement suspected with clubbing) and is trying to address both a cold and possibility of underlying increased lung involvement....
 
C

crickit715

New member
did you ask why he was putting her on the bactrim? a few weeks ago my daughter was sick with a virus and they had her take bactrim also (which of course, antibiotics dont help virus') so i asked them why the bactrim and they told me that it was to help "keep the other stuff (bacteria) in her lungs at bay" while they deal with this virus. when she has a post nasal drip or sinus issues with coughing it always ends up stirring the staph aureus back up in her lungs and starting that problem. i would just call them and ask before starting it. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
C

crickit715

New member
did you ask why he was putting her on the bactrim? a few weeks ago my daughter was sick with a virus and they had her take bactrim also (which of course, antibiotics dont help virus') so i asked them why the bactrim and they told me that it was to help "keep the other stuff (bacteria) in her lungs at bay" while they deal with this virus. when she has a post nasal drip or sinus issues with coughing it always ends up stirring the staph aureus back up in her lungs and starting that problem. i would just call them and ask before starting it. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
C

crickit715

New member
did you ask why he was putting her on the bactrim? a few weeks ago my daughter was sick with a virus and they had her take bactrim also (which of course, antibiotics dont help virus') so i asked them why the bactrim and they told me that it was to help "keep the other stuff (bacteria) in her lungs at bay" while they deal with this virus. when she has a post nasal drip or sinus issues with coughing it always ends up stirring the staph aureus back up in her lungs and starting that problem. i would just call them and ask before starting it. <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
P

petnurse

New member
Katie,
Philip cultures staph. Anytime he has ANY increased mucus production (with or without cough), the CF doc puts him on Bactrim. He does this because if there is mucus anywhere, we know it is going to get thick in the lungs. The dormant staph will proliferate and grow out of control if given the right opportunity (which we know does not take long). I would guess this is why she was started on Bactrim. My dr has even prescribed it because the other kids were sick (not something we would do for a normal kid obviously). Good luck. I have been thinking of you guys <3
 
P

petnurse

New member
Katie,
Philip cultures staph. Anytime he has ANY increased mucus production (with or without cough), the CF doc puts him on Bactrim. He does this because if there is mucus anywhere, we know it is going to get thick in the lungs. The dormant staph will proliferate and grow out of control if given the right opportunity (which we know does not take long). I would guess this is why she was started on Bactrim. My dr has even prescribed it because the other kids were sick (not something we would do for a normal kid obviously). Good luck. I have been thinking of you guys <3
 
P

petnurse

New member
Katie,
<br />Philip cultures staph. Anytime he has ANY increased mucus production (with or without cough), the CF doc puts him on Bactrim. He does this because if there is mucus anywhere, we know it is going to get thick in the lungs. The dormant staph will proliferate and grow out of control if given the right opportunity (which we know does not take long). I would guess this is why she was started on Bactrim. My dr has even prescribed it because the other kids were sick (not something we would do for a normal kid obviously). Good luck. I have been thinking of you guys <3
 
M

Mommafirst

Guest
Katie,

When they do a culture they can see if the number of staph is high or not. Possibly her last culture showed it was increasing and now with the increased mucus in her lungs and the rumbles the bactrim is to knock down the number of staph and to prevent overgrowth.

Alyssa has been on bactrim many times for her staph. I know its frustrating to feel like you are risking desensitizing her staph for the bactrim, but there are many other meds that staph responds to, and from what I understand using something else for awhile can mean she will grow sensitive to the bactrim again. It safer to attack the staph when there are small issues now, than to let it do potential damage to the lungs just to preserve the bactrim as a possible tool.
 
M

Mommafirst

Guest
Katie,

When they do a culture they can see if the number of staph is high or not. Possibly her last culture showed it was increasing and now with the increased mucus in her lungs and the rumbles the bactrim is to knock down the number of staph and to prevent overgrowth.

Alyssa has been on bactrim many times for her staph. I know its frustrating to feel like you are risking desensitizing her staph for the bactrim, but there are many other meds that staph responds to, and from what I understand using something else for awhile can mean she will grow sensitive to the bactrim again. It safer to attack the staph when there are small issues now, than to let it do potential damage to the lungs just to preserve the bactrim as a possible tool.
 
M

Mommafirst

Guest
Katie,
<br />
<br />When they do a culture they can see if the number of staph is high or not. Possibly her last culture showed it was increasing and now with the increased mucus in her lungs and the rumbles the bactrim is to knock down the number of staph and to prevent overgrowth.
<br />
<br />Alyssa has been on bactrim many times for her staph. I know its frustrating to feel like you are risking desensitizing her staph for the bactrim, but there are many other meds that staph responds to, and from what I understand using something else for awhile can mean she will grow sensitive to the bactrim again. It safer to attack the staph when there are small issues now, than to let it do potential damage to the lungs just to preserve the bactrim as a possible tool.
 
H

hmw

New member
I pretty much agree with the others. Since she DOES culture staph, whenever she gets sick with any kind of bug (cold, other uri) the staph production can go into overdrive and very easily cause an exacerbation. In my opinion, the fact that he heard noise when he listened to her may be more significant than the fact that she was coughing the other day. Kids can be coughing like crazy and turn out to be largely due to sinus congestion (postnasal drip.) Hearing it in the chest is a clear sign that it needs to be addressed.

It's easier to keep this in check by rx'ing something the staph is sensitive sooner rather than later. If you wait until they are really, really sick they are much more likely to need higher doses of abx, possibly more than one abx, and the staph can grow more resistant upon exposure to more drugs.

Emily cultures staph as well, and we use abx when Emily has any kind of bug that doesn't respond to increased tx... sooner if it's lower respiratory, but even if it's a head cold/sinuses, if it doesn't go away fairly quickly, we get her on abx. Oh, and fwiw, Emily also has some clubbing. The dr hasn't really correlated it to degree of lung damage/made a big deal out of it, but it's been noted by a couple of her drs. Her latest 'healthy' chest xray several months ago did show early signs of cf related damage (vs a perfectly normal one a couple yrs ago), but she's 9.5 and has had a lot more infection/illness than Ellie.
 
H

hmw

New member
I pretty much agree with the others. Since she DOES culture staph, whenever she gets sick with any kind of bug (cold, other uri) the staph production can go into overdrive and very easily cause an exacerbation. In my opinion, the fact that he heard noise when he listened to her may be more significant than the fact that she was coughing the other day. Kids can be coughing like crazy and turn out to be largely due to sinus congestion (postnasal drip.) Hearing it in the chest is a clear sign that it needs to be addressed.

It's easier to keep this in check by rx'ing something the staph is sensitive sooner rather than later. If you wait until they are really, really sick they are much more likely to need higher doses of abx, possibly more than one abx, and the staph can grow more resistant upon exposure to more drugs.

Emily cultures staph as well, and we use abx when Emily has any kind of bug that doesn't respond to increased tx... sooner if it's lower respiratory, but even if it's a head cold/sinuses, if it doesn't go away fairly quickly, we get her on abx. Oh, and fwiw, Emily also has some clubbing. The dr hasn't really correlated it to degree of lung damage/made a big deal out of it, but it's been noted by a couple of her drs. Her latest 'healthy' chest xray several months ago did show early signs of cf related damage (vs a perfectly normal one a couple yrs ago), but she's 9.5 and has had a lot more infection/illness than Ellie.
 
H

hmw

New member
I pretty much agree with the others. Since she DOES culture staph, whenever she gets sick with any kind of bug (cold, other uri) the staph production can go into overdrive and very easily cause an exacerbation. In my opinion, the fact that he heard noise when he listened to her may be more significant than the fact that she was coughing the other day. Kids can be coughing like crazy and turn out to be largely due to sinus congestion (postnasal drip.) Hearing it in the chest is a clear sign that it needs to be addressed.
<br />
<br />It's easier to keep this in check by rx'ing something the staph is sensitive sooner rather than later. If you wait until they are really, really sick they are much more likely to need higher doses of abx, possibly more than one abx, and the staph can grow more resistant upon exposure to more drugs.
<br />
<br />Emily cultures staph as well, and we use abx when Emily has any kind of bug that doesn't respond to increased tx... sooner if it's lower respiratory, but even if it's a head cold/sinuses, if it doesn't go away fairly quickly, we get her on abx. Oh, and fwiw, Emily also has some clubbing. The dr hasn't really correlated it to degree of lung damage/made a big deal out of it, but it's been noted by a couple of her drs. Her latest 'healthy' chest xray several months ago did show early signs of cf related damage (vs a perfectly normal one a couple yrs ago), but she's 9.5 and has had a lot more infection/illness than Ellie.
<br />
 
K

kitomd21

New member
Thank you everybody. I think the issue with this doctor is that he's so dry and to the point that he doesn't elaborate on much of anything - leaves me with questions all the time! <img src="i/expressions/face-icon-small-smile.gif" border="0"> I have a tendency not to trust doctors...I assume they're all bound to be wrong and I'm always on guard. A good thing and a bad thing, I suppose. Hopefully I'll still catch when they are "wrong" about something by being vigilant.

Thanks for your input, Harriet. He didn't seem too alarmed by the clubbing until we have a follow-up XRAY from over a year ago. If the XRAY is concerning, he's going to order a bronchoscopy or CT scan....again, he didn't really elaborate on the causes on clubbing. He really doesn't address anything unless he really needs to, it seems. Just a difficult person to read!!
 
K

kitomd21

New member
Thank you everybody. I think the issue with this doctor is that he's so dry and to the point that he doesn't elaborate on much of anything - leaves me with questions all the time! <img src="i/expressions/face-icon-small-smile.gif" border="0"> I have a tendency not to trust doctors...I assume they're all bound to be wrong and I'm always on guard. A good thing and a bad thing, I suppose. Hopefully I'll still catch when they are "wrong" about something by being vigilant.

Thanks for your input, Harriet. He didn't seem too alarmed by the clubbing until we have a follow-up XRAY from over a year ago. If the XRAY is concerning, he's going to order a bronchoscopy or CT scan....again, he didn't really elaborate on the causes on clubbing. He really doesn't address anything unless he really needs to, it seems. Just a difficult person to read!!
 
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