Nathan use to grow both of those all the time, he still grows staph a lot. It is my understanding that the H flu is common for the younger ones and eventually they don't grow it, or at least not as often.
He probably will cough during the vest and "hugh coughs" but most likely the cough will or should diminish shortly afterwards if the albeterol is truly helping. However, if Nathan is growing something in his cultures at all and is having any symptoms, ie cough, Dr. Accurso almost always starts an antibiiotic. If he just finished one and the cough comes back shortly after stopping and he grew something, he starts him back on one again and does a longer course. I know that each CFer is different, and some doctors are really conservative with antibiotics because of the risks of overuse, but I would think with the time of year, if I were you, I would push the issue and call everyday the cough is not better, but that is just me. Plus, I know Nathan really well after doing this for 14 years and have a really good sense of when to ignore his cough and when not to ignore it. I guess what I am really trying to say is to follow your gut and be persistant with what your instincts are telling you unless they can give you a really good reason not to or you feel comfortable. Is the albuterol helping at all? If it is, then maybe they are right, but I would ask them for how long should you use the increased amount of albeterol safely.
Truly, follow your instincts, they really are the best guage. Nathan did not have an increased cough unless he was growing something that needed treatment, such as the staph and/or H flu without other symptoms that had nothing to do with the staph and H flue like a fever, aches, other cold symptoms like sore throat, runny nose, etc., if it was just an increase in cough it was almost always, if not always, CF related.
By the way, anytime I was not confident in what someone at the CF center told me, I would go directly to the doctor. As matter of fact, I almost always just email Nathan's doctor directly now and CC one of the nurses so that should he want something ordered, they can order it for me and are already aware of the conversation. The only time I call, is if it is emergent and I need an immediate answer that can't wait for emails to go back and forth, which is rare, unless I know that his doctor is out of the area. Then, I was given all of his phone numbers including his cell and home phone numbers and now I have all his numbers plus his email. It is amazing how the other staff responds to you when they know that you can go directly to the doctor and completely bypass them if you want too and they know that you will do it if you are not satisfied with their answers. If you have the ability to go directly to the doctor, do it, they don't give you such information if they don't want you to use it. I know I had it for a long time before I got brave enough to use it and now I have no problem doing so.