oral antibiotic resistence?

Mommafirst · Feb 19, 2009

How often does this happen? Is it common for CF patients to develop antibiotic resistence? Alyssa has done very well, but when she gets a respirator cold it she winds up on antibiotics.

In October, she was on Augmentin for a week without any relief, then switched to Bactrim for a few days when her breathing got so labored from bronchitis that she was retracting. The CF docs declared the oral abx useless this time and she went onto IVs. Within 4 days on IV abx she stopped coughing, but we finished the 2 week course.

She is coughing again and its a doozy. Our CF doc said he'd like to wait it out a few days without any meds to see if she can clear it on her own. He is concerned that too many abx will just quicken her likelihood for resistence. I am really concerned that we'll be back in the hospital by next week. Doesn't she seem really young (just turned three) to have built a resistence already??

She has only had throat cultures and always cultures Staph A. She usually gets one clean culture post abx, but the staph comes back by the following culture. She's never cultured PA or MRSA.

Mommafirst · Feb 19, 2009

How often does this happen? Is it common for CF patients to develop antibiotic resistence? Alyssa has done very well, but when she gets a respirator cold it she winds up on antibiotics.

In October, she was on Augmentin for a week without any relief, then switched to Bactrim for a few days when her breathing got so labored from bronchitis that she was retracting. The CF docs declared the oral abx useless this time and she went onto IVs. Within 4 days on IV abx she stopped coughing, but we finished the 2 week course.

She is coughing again and its a doozy. Our CF doc said he'd like to wait it out a few days without any meds to see if she can clear it on her own. He is concerned that too many abx will just quicken her likelihood for resistence. I am really concerned that we'll be back in the hospital by next week. Doesn't she seem really young (just turned three) to have built a resistence already??

She has only had throat cultures and always cultures Staph A. She usually gets one clean culture post abx, but the staph comes back by the following culture. She's never cultured PA or MRSA.

Mommafirst · Feb 19, 2009

How often does this happen? Is it common for CF patients to develop antibiotic resistence? Alyssa has done very well, but when she gets a respirator cold it she winds up on antibiotics.

In October, she was on Augmentin for a week without any relief, then switched to Bactrim for a few days when her breathing got so labored from bronchitis that she was retracting. The CF docs declared the oral abx useless this time and she went onto IVs. Within 4 days on IV abx she stopped coughing, but we finished the 2 week course.

She is coughing again and its a doozy. Our CF doc said he'd like to wait it out a few days without any meds to see if she can clear it on her own. He is concerned that too many abx will just quicken her likelihood for resistence. I am really concerned that we'll be back in the hospital by next week. Doesn't she seem really young (just turned three) to have built a resistence already??

She has only had throat cultures and always cultures Staph A. She usually gets one clean culture post abx, but the staph comes back by the following culture. She's never cultured PA or MRSA.

Mommafirst · Feb 19, 2009

How often does this happen? Is it common for CF patients to develop antibiotic resistence? Alyssa has done very well, but when she gets a respirator cold it she winds up on antibiotics.

In October, she was on Augmentin for a week without any relief, then switched to Bactrim for a few days when her breathing got so labored from bronchitis that she was retracting. The CF docs declared the oral abx useless this time and she went onto IVs. Within 4 days on IV abx she stopped coughing, but we finished the 2 week course.

She is coughing again and its a doozy. Our CF doc said he'd like to wait it out a few days without any meds to see if she can clear it on her own. He is concerned that too many abx will just quicken her likelihood for resistence. I am really concerned that we'll be back in the hospital by next week. Doesn't she seem really young (just turned three) to have built a resistence already??

She has only had throat cultures and always cultures Staph A. She usually gets one clean culture post abx, but the staph comes back by the following culture. She's never cultured PA or MRSA.

Mommafirst · Feb 19, 2009

How often does this happen? Is it common for CF patients to develop antibiotic resistence? Alyssa has done very well, but when she gets a respirator cold it she winds up on antibiotics.
 
 In October, she was on Augmentin for a week without any relief, then switched to Bactrim for a few days when her breathing got so labored from bronchitis that she was retracting. The CF docs declared the oral abx useless this time and she went onto IVs. Within 4 days on IV abx she stopped coughing, but we finished the 2 week course.
 
 She is coughing again and its a doozy. Our CF doc said he'd like to wait it out a few days without any meds to see if she can clear it on her own. He is concerned that too many abx will just quicken her likelihood for resistence. I am really concerned that we'll be back in the hospital by next week. Doesn't she seem really young (just turned three) to have built a resistence already??
 
 She has only had throat cultures and always cultures Staph A. She usually gets one clean culture post abx, but the staph comes back by the following culture. She's never cultured PA or MRSA.

Nightwriter · Feb 19, 2009

It took me a really long time to become resistant to antibiotics. But you have to remember that was years ago. Nowadays because of the overuse of antibiotics, we have things like MRSA, as the bugs get stronger in our world as a whole. So I suspect quicker resistance is a problem.

I can relate to what you are saying. When I first showed symptoms for CF at 21, I was on Amoxicillin, then Augmentin as well as similar drugs every few months. A cold always ended up in my chest too. I got Pseudomonas almost immediately so although these antibiotics did seem to help, I wonder now what they working on, since it was NOT the Pseudomonas. I took Bactrim every day for over 10 years.

If I took Augmentin (and the others) and it didn't work, I'd have to go on IV meds. It was explained to me that the Pseudomonas count would build up until I needed IV antibiotics. It helped tremndously when Cipro came on the market and after a while I became resistant to that which meant IV's again. Then Tobi, and eventually I became resistant to that. I was never prescribed Augmentin (and the similar drugs) again because they didn't seem to work on anything. To this day, I don't know what the Augmentin did, and I wonder if I would have recovered without it.

There was a point when I didn't want to be on antibiotics too much, so when I got sick, I would do tons of extra breathing treatments (without mucus clearance-- I didn't know about it.) to see if I could avoid antibiotics and sometimes was able to. Other times, it turned into a terrible infection.

Nowadays, I take home remedies to avoid colds altogether, so I don't have colds turning into bronchitis any more. When I get sick now which is much rarer because I treat the asthma component to CF, usually my doctor treats it as inflammation and may change my meds. I then have to stay home, do extra treatments with mucus clearance, and occasionally it requires a cortisone shot or two, in addition to some other things. So most of the time I can avoid antibiotics (under my doctor's guidance).

However, if it does turn into an infection, then I do a course of Tobi for 2 to 4 weeks.

When I have an exacerbation these days, I have to look for any unusual exposures that may have caused it -- which helps determine whether it is inflammation or infection. Then I have to try to get my airways as open as possible, thin the mucus, and get as much mucus out of my lungs as I can. If cortisone is required, it is to reduce the inflammation which causes that the airways to swell (which traps the mucus with the bacteria).

I can understand your concern, because for me in the old days a cold meant bronchitis 100% of the time. Has your doctor given you a treatment plan of some kind, or is he just hoping it goes away on it's own, which does seem unlikely.

In any event, I do hope it just resolves itself.

Nightwriter · Feb 19, 2009

It took me a really long time to become resistant to antibiotics. But you have to remember that was years ago. Nowadays because of the overuse of antibiotics, we have things like MRSA, as the bugs get stronger in our world as a whole. So I suspect quicker resistance is a problem.

I can relate to what you are saying. When I first showed symptoms for CF at 21, I was on Amoxicillin, then Augmentin as well as similar drugs every few months. A cold always ended up in my chest too. I got Pseudomonas almost immediately so although these antibiotics did seem to help, I wonder now what they working on, since it was NOT the Pseudomonas. I took Bactrim every day for over 10 years.

If I took Augmentin (and the others) and it didn't work, I'd have to go on IV meds. It was explained to me that the Pseudomonas count would build up until I needed IV antibiotics. It helped tremndously when Cipro came on the market and after a while I became resistant to that which meant IV's again. Then Tobi, and eventually I became resistant to that. I was never prescribed Augmentin (and the similar drugs) again because they didn't seem to work on anything. To this day, I don't know what the Augmentin did, and I wonder if I would have recovered without it.

There was a point when I didn't want to be on antibiotics too much, so when I got sick, I would do tons of extra breathing treatments (without mucus clearance-- I didn't know about it.) to see if I could avoid antibiotics and sometimes was able to. Other times, it turned into a terrible infection.

Nowadays, I take home remedies to avoid colds altogether, so I don't have colds turning into bronchitis any more. When I get sick now which is much rarer because I treat the asthma component to CF, usually my doctor treats it as inflammation and may change my meds. I then have to stay home, do extra treatments with mucus clearance, and occasionally it requires a cortisone shot or two, in addition to some other things. So most of the time I can avoid antibiotics (under my doctor's guidance).

However, if it does turn into an infection, then I do a course of Tobi for 2 to 4 weeks.

When I have an exacerbation these days, I have to look for any unusual exposures that may have caused it -- which helps determine whether it is inflammation or infection. Then I have to try to get my airways as open as possible, thin the mucus, and get as much mucus out of my lungs as I can. If cortisone is required, it is to reduce the inflammation which causes that the airways to swell (which traps the mucus with the bacteria).

I can understand your concern, because for me in the old days a cold meant bronchitis 100% of the time. Has your doctor given you a treatment plan of some kind, or is he just hoping it goes away on it's own, which does seem unlikely.

In any event, I do hope it just resolves itself.

Nightwriter · Feb 19, 2009

It took me a really long time to become resistant to antibiotics. But you have to remember that was years ago. Nowadays because of the overuse of antibiotics, we have things like MRSA, as the bugs get stronger in our world as a whole. So I suspect quicker resistance is a problem.

I can relate to what you are saying. When I first showed symptoms for CF at 21, I was on Amoxicillin, then Augmentin as well as similar drugs every few months. A cold always ended up in my chest too. I got Pseudomonas almost immediately so although these antibiotics did seem to help, I wonder now what they working on, since it was NOT the Pseudomonas. I took Bactrim every day for over 10 years.

If I took Augmentin (and the others) and it didn't work, I'd have to go on IV meds. It was explained to me that the Pseudomonas count would build up until I needed IV antibiotics. It helped tremndously when Cipro came on the market and after a while I became resistant to that which meant IV's again. Then Tobi, and eventually I became resistant to that. I was never prescribed Augmentin (and the similar drugs) again because they didn't seem to work on anything. To this day, I don't know what the Augmentin did, and I wonder if I would have recovered without it.

There was a point when I didn't want to be on antibiotics too much, so when I got sick, I would do tons of extra breathing treatments (without mucus clearance-- I didn't know about it.) to see if I could avoid antibiotics and sometimes was able to. Other times, it turned into a terrible infection.

Nowadays, I take home remedies to avoid colds altogether, so I don't have colds turning into bronchitis any more. When I get sick now which is much rarer because I treat the asthma component to CF, usually my doctor treats it as inflammation and may change my meds. I then have to stay home, do extra treatments with mucus clearance, and occasionally it requires a cortisone shot or two, in addition to some other things. So most of the time I can avoid antibiotics (under my doctor's guidance).

However, if it does turn into an infection, then I do a course of Tobi for 2 to 4 weeks.

When I have an exacerbation these days, I have to look for any unusual exposures that may have caused it -- which helps determine whether it is inflammation or infection. Then I have to try to get my airways as open as possible, thin the mucus, and get as much mucus out of my lungs as I can. If cortisone is required, it is to reduce the inflammation which causes that the airways to swell (which traps the mucus with the bacteria).

I can understand your concern, because for me in the old days a cold meant bronchitis 100% of the time. Has your doctor given you a treatment plan of some kind, or is he just hoping it goes away on it's own, which does seem unlikely.

In any event, I do hope it just resolves itself.

Nightwriter · Feb 19, 2009

It took me a really long time to become resistant to antibiotics. But you have to remember that was years ago. Nowadays because of the overuse of antibiotics, we have things like MRSA, as the bugs get stronger in our world as a whole. So I suspect quicker resistance is a problem.

I can relate to what you are saying. When I first showed symptoms for CF at 21, I was on Amoxicillin, then Augmentin as well as similar drugs every few months. A cold always ended up in my chest too. I got Pseudomonas almost immediately so although these antibiotics did seem to help, I wonder now what they working on, since it was NOT the Pseudomonas. I took Bactrim every day for over 10 years.

If I took Augmentin (and the others) and it didn't work, I'd have to go on IV meds. It was explained to me that the Pseudomonas count would build up until I needed IV antibiotics. It helped tremndously when Cipro came on the market and after a while I became resistant to that which meant IV's again. Then Tobi, and eventually I became resistant to that. I was never prescribed Augmentin (and the similar drugs) again because they didn't seem to work on anything. To this day, I don't know what the Augmentin did, and I wonder if I would have recovered without it.

There was a point when I didn't want to be on antibiotics too much, so when I got sick, I would do tons of extra breathing treatments (without mucus clearance-- I didn't know about it.) to see if I could avoid antibiotics and sometimes was able to. Other times, it turned into a terrible infection.

Nowadays, I take home remedies to avoid colds altogether, so I don't have colds turning into bronchitis any more. When I get sick now which is much rarer because I treat the asthma component to CF, usually my doctor treats it as inflammation and may change my meds. I then have to stay home, do extra treatments with mucus clearance, and occasionally it requires a cortisone shot or two, in addition to some other things. So most of the time I can avoid antibiotics (under my doctor's guidance).

However, if it does turn into an infection, then I do a course of Tobi for 2 to 4 weeks.

When I have an exacerbation these days, I have to look for any unusual exposures that may have caused it -- which helps determine whether it is inflammation or infection. Then I have to try to get my airways as open as possible, thin the mucus, and get as much mucus out of my lungs as I can. If cortisone is required, it is to reduce the inflammation which causes that the airways to swell (which traps the mucus with the bacteria).

I can understand your concern, because for me in the old days a cold meant bronchitis 100% of the time. Has your doctor given you a treatment plan of some kind, or is he just hoping it goes away on it's own, which does seem unlikely.

In any event, I do hope it just resolves itself.

Nightwriter · Feb 19, 2009

It took me a really long time to become resistant to antibiotics. But you have to remember that was years ago. Nowadays because of the overuse of antibiotics, we have things like MRSA, as the bugs get stronger in our world as a whole. So I suspect quicker resistance is a problem.
 
 I can relate to what you are saying. When I first showed symptoms for CF at 21, I was on Amoxicillin, then Augmentin as well as similar drugs every few months. A cold always ended up in my chest too. I got Pseudomonas almost immediately so although these antibiotics did seem to help, I wonder now what they working on, since it was NOT the Pseudomonas. I took Bactrim every day for over 10 years.
 
 If I took Augmentin (and the others) and it didn't work, I'd have to go on IV meds. It was explained to me that the Pseudomonas count would build up until I needed IV antibiotics. It helped tremndously when Cipro came on the market and after a while I became resistant to that which meant IV's again. Then Tobi, and eventually I became resistant to that. I was never prescribed Augmentin (and the similar drugs) again because they didn't seem to work on anything. To this day, I don't know what the Augmentin did, and I wonder if I would have recovered without it.
 
 There was a point when I didn't want to be on antibiotics too much, so when I got sick, I would do tons of extra breathing treatments (without mucus clearance-- I didn't know about it.) to see if I could avoid antibiotics and sometimes was able to. Other times, it turned into a terrible infection.
 
 Nowadays, I take home remedies to avoid colds altogether, so I don't have colds turning into bronchitis any more. When I get sick now which is much rarer because I treat the asthma component to CF, usually my doctor treats it as inflammation and may change my meds. I then have to stay home, do extra treatments with mucus clearance, and occasionally it requires a cortisone shot or two, in addition to some other things. So most of the time I can avoid antibiotics (under my doctor's guidance).
 
 However, if it does turn into an infection, then I do a course of Tobi for 2 to 4 weeks.
 
 When I have an exacerbation these days, I have to look for any unusual exposures that may have caused it -- which helps determine whether it is inflammation or infection. Then I have to try to get my airways as open as possible, thin the mucus, and get as much mucus out of my lungs as I can. If cortisone is required, it is to reduce the inflammation which causes that the airways to swell (which traps the mucus with the bacteria).
 
 
 I can understand your concern, because for me in the old days a cold meant bronchitis 100% of the time. Has your doctor given you a treatment plan of some kind, or is he just hoping it goes away on it's own, which does seem unlikely.
 
 In any event, I do hope it just resolves itself.

Ratatosk · Feb 19, 2009

There are some bugs that are cultured that are resistant from day one. When DS cultured Steno. Malt. the lab report indicated it was resistant to several meds that he'd never, ever been on before.

His local cf doctors are constantly concerned with ABX resistance and chastise us because of the meds his primary cf doctor in the city prescribes. However, his primary cf doctor is also an ID specialist, and I guess we're more confident in the way he does things.

DS hasn't cultured staph, but from what I understand from other cf parents in the area who go to another cf clinic in the city is that their doctors usually prescribe bactrim if they get the junky sounding cough. Does your doctor have a time frame to wait it out? Usually after 'x' number of days after upping cpt, etc...

Ratatosk · Feb 19, 2009

There are some bugs that are cultured that are resistant from day one. When DS cultured Steno. Malt. the lab report indicated it was resistant to several meds that he'd never, ever been on before.

His local cf doctors are constantly concerned with ABX resistance and chastise us because of the meds his primary cf doctor in the city prescribes. However, his primary cf doctor is also an ID specialist, and I guess we're more confident in the way he does things.

DS hasn't cultured staph, but from what I understand from other cf parents in the area who go to another cf clinic in the city is that their doctors usually prescribe bactrim if they get the junky sounding cough. Does your doctor have a time frame to wait it out? Usually after 'x' number of days after upping cpt, etc...

Ratatosk · Feb 19, 2009

There are some bugs that are cultured that are resistant from day one. When DS cultured Steno. Malt. the lab report indicated it was resistant to several meds that he'd never, ever been on before.

His local cf doctors are constantly concerned with ABX resistance and chastise us because of the meds his primary cf doctor in the city prescribes. However, his primary cf doctor is also an ID specialist, and I guess we're more confident in the way he does things.

DS hasn't cultured staph, but from what I understand from other cf parents in the area who go to another cf clinic in the city is that their doctors usually prescribe bactrim if they get the junky sounding cough. Does your doctor have a time frame to wait it out? Usually after 'x' number of days after upping cpt, etc...

Ratatosk · Feb 19, 2009

There are some bugs that are cultured that are resistant from day one. When DS cultured Steno. Malt. the lab report indicated it was resistant to several meds that he'd never, ever been on before.

His local cf doctors are constantly concerned with ABX resistance and chastise us because of the meds his primary cf doctor in the city prescribes. However, his primary cf doctor is also an ID specialist, and I guess we're more confident in the way he does things.

DS hasn't cultured staph, but from what I understand from other cf parents in the area who go to another cf clinic in the city is that their doctors usually prescribe bactrim if they get the junky sounding cough. Does your doctor have a time frame to wait it out? Usually after 'x' number of days after upping cpt, etc...

Ratatosk · Feb 19, 2009

There are some bugs that are cultured that are resistant from day one. When DS cultured Steno. Malt. the lab report indicated it was resistant to several meds that he'd never, ever been on before.
 
 His local cf doctors are constantly concerned with ABX resistance and chastise us because of the meds his primary cf doctor in the city prescribes. However, his primary cf doctor is also an ID specialist, and I guess we're more confident in the way he does things.
 
 DS hasn't cultured staph, but from what I understand from other cf parents in the area who go to another cf clinic in the city is that their doctors usually prescribe bactrim if they get the junky sounding cough. Does your doctor have a time frame to wait it out? Usually after 'x' number of days after upping cpt, etc...

saveferris2009 · Feb 19, 2009

The problem is, Heather, she can catch bacteria that are already resistant to antibiotics. So it's not necessarily how often SHE has used antibiotics - it's like Nightwriter says - it's a whole community thing.

Many patients at your clinic probably have multi drug resistant PA. If she picks that up from another CFer or from a door nob or chair or carpet at the clinic (PA can remain on surfaces for 7+ days) whatever the PA is MDR to, she won't be able to use those antibiotics either.

Remember as well, usually when we're on IV's we're on more than 1 med. 2 meds work synergisticly (1+1=3) to overcome resistance.

There are many thoughts on resistance - if you examine older patients with CF who have passed, not all (and some would venture to say not many) die with pan-resistance. They die due to permanent lung damange.

Which leads to the different schools of thought of how aggressive to be with antibiotics - Denmark has ridiculously high life expectancy rates which many attribute to aggressive use of antibiotics (every 3 months, whether you are sick or not) because this prevents permanent lung damage per their theory. Do they have higher resistance rates? You bet. But they're also living longer.

So do keep in mind - waiting to go on abx can lead to permanent lung damage and of course as everyone said this must be weighed with abx overuse. But it's important to understand the different schools of thought.

But I personally know a few CFer's who do IV's 2x a year because orals don't work for them at a very very young age (2 years+). So this isn't unique.

Think of every IV use as preserving lung function - a 2 week investment in the prolonging of your daughter's life <img src="i/expressions/face-icon-small-smile.gif" border="0">

On a side note, I love nightwriter's philosophy of preventing colds. I had 5 (count 'em, 5) last year and none (knock on wood) this year and I'm pretty sure it's because I'm far more away of my hands touching my face. I know it's more difficult with a 3 year old, but I still think it's a great idea to keep in mind <img src="i/expressions/face-icon-small-smile.gif" border="0">

saveferris2009 · Feb 19, 2009

The problem is, Heather, she can catch bacteria that are already resistant to antibiotics. So it's not necessarily how often SHE has used antibiotics - it's like Nightwriter says - it's a whole community thing.

Many patients at your clinic probably have multi drug resistant PA. If she picks that up from another CFer or from a door nob or chair or carpet at the clinic (PA can remain on surfaces for 7+ days) whatever the PA is MDR to, she won't be able to use those antibiotics either.

Remember as well, usually when we're on IV's we're on more than 1 med. 2 meds work synergisticly (1+1=3) to overcome resistance.

There are many thoughts on resistance - if you examine older patients with CF who have passed, not all (and some would venture to say not many) die with pan-resistance. They die due to permanent lung damange.

Which leads to the different schools of thought of how aggressive to be with antibiotics - Denmark has ridiculously high life expectancy rates which many attribute to aggressive use of antibiotics (every 3 months, whether you are sick or not) because this prevents permanent lung damage per their theory. Do they have higher resistance rates? You bet. But they're also living longer.

So do keep in mind - waiting to go on abx can lead to permanent lung damage and of course as everyone said this must be weighed with abx overuse. But it's important to understand the different schools of thought.

But I personally know a few CFer's who do IV's 2x a year because orals don't work for them at a very very young age (2 years+). So this isn't unique.

Think of every IV use as preserving lung function - a 2 week investment in the prolonging of your daughter's life <img src="i/expressions/face-icon-small-smile.gif" border="0">

On a side note, I love nightwriter's philosophy of preventing colds. I had 5 (count 'em, 5) last year and none (knock on wood) this year and I'm pretty sure it's because I'm far more away of my hands touching my face. I know it's more difficult with a 3 year old, but I still think it's a great idea to keep in mind <img src="i/expressions/face-icon-small-smile.gif" border="0">

saveferris2009 · Feb 19, 2009

The problem is, Heather, she can catch bacteria that are already resistant to antibiotics. So it's not necessarily how often SHE has used antibiotics - it's like Nightwriter says - it's a whole community thing.

Many patients at your clinic probably have multi drug resistant PA. If she picks that up from another CFer or from a door nob or chair or carpet at the clinic (PA can remain on surfaces for 7+ days) whatever the PA is MDR to, she won't be able to use those antibiotics either.

Remember as well, usually when we're on IV's we're on more than 1 med. 2 meds work synergisticly (1+1=3) to overcome resistance.

There are many thoughts on resistance - if you examine older patients with CF who have passed, not all (and some would venture to say not many) die with pan-resistance. They die due to permanent lung damange.

Which leads to the different schools of thought of how aggressive to be with antibiotics - Denmark has ridiculously high life expectancy rates which many attribute to aggressive use of antibiotics (every 3 months, whether you are sick or not) because this prevents permanent lung damage per their theory. Do they have higher resistance rates? You bet. But they're also living longer.

So do keep in mind - waiting to go on abx can lead to permanent lung damage and of course as everyone said this must be weighed with abx overuse. But it's important to understand the different schools of thought.

But I personally know a few CFer's who do IV's 2x a year because orals don't work for them at a very very young age (2 years+). So this isn't unique.

Think of every IV use as preserving lung function - a 2 week investment in the prolonging of your daughter's life <img src="i/expressions/face-icon-small-smile.gif" border="0">

On a side note, I love nightwriter's philosophy of preventing colds. I had 5 (count 'em, 5) last year and none (knock on wood) this year and I'm pretty sure it's because I'm far more away of my hands touching my face. I know it's more difficult with a 3 year old, but I still think it's a great idea to keep in mind <img src="i/expressions/face-icon-small-smile.gif" border="0">

saveferris2009 · Feb 19, 2009

The problem is, Heather, she can catch bacteria that are already resistant to antibiotics. So it's not necessarily how often SHE has used antibiotics - it's like Nightwriter says - it's a whole community thing.

Many patients at your clinic probably have multi drug resistant PA. If she picks that up from another CFer or from a door nob or chair or carpet at the clinic (PA can remain on surfaces for 7+ days) whatever the PA is MDR to, she won't be able to use those antibiotics either.

Remember as well, usually when we're on IV's we're on more than 1 med. 2 meds work synergisticly (1+1=3) to overcome resistance.

There are many thoughts on resistance - if you examine older patients with CF who have passed, not all (and some would venture to say not many) die with pan-resistance. They die due to permanent lung damange.

Which leads to the different schools of thought of how aggressive to be with antibiotics - Denmark has ridiculously high life expectancy rates which many attribute to aggressive use of antibiotics (every 3 months, whether you are sick or not) because this prevents permanent lung damage per their theory. Do they have higher resistance rates? You bet. But they're also living longer.

So do keep in mind - waiting to go on abx can lead to permanent lung damage and of course as everyone said this must be weighed with abx overuse. But it's important to understand the different schools of thought.

But I personally know a few CFer's who do IV's 2x a year because orals don't work for them at a very very young age (2 years+). So this isn't unique.

Think of every IV use as preserving lung function - a 2 week investment in the prolonging of your daughter's life <img src="i/expressions/face-icon-small-smile.gif" border="0">

On a side note, I love nightwriter's philosophy of preventing colds. I had 5 (count 'em, 5) last year and none (knock on wood) this year and I'm pretty sure it's because I'm far more away of my hands touching my face. I know it's more difficult with a 3 year old, but I still think it's a great idea to keep in mind <img src="i/expressions/face-icon-small-smile.gif" border="0">

saveferris2009 · Feb 19, 2009

The problem is, Heather, she can catch bacteria that are already resistant to antibiotics. So it's not necessarily how often SHE has used antibiotics - it's like Nightwriter says - it's a whole community thing.
 
 Many patients at your clinic probably have multi drug resistant PA. If she picks that up from another CFer or from a door nob or chair or carpet at the clinic (PA can remain on surfaces for 7+ days) whatever the PA is MDR to, she won't be able to use those antibiotics either.
 
 Remember as well, usually when we're on IV's we're on more than 1 med. 2 meds work synergisticly (1+1=3) to overcome resistance.
 
 There are many thoughts on resistance - if you examine older patients with CF who have passed, not all (and some would venture to say not many) die with pan-resistance. They die due to permanent lung damange.
 
 Which leads to the different schools of thought of how aggressive to be with antibiotics - Denmark has ridiculously high life expectancy rates which many attribute to aggressive use of antibiotics (every 3 months, whether you are sick or not) because this prevents permanent lung damage per their theory. Do they have higher resistance rates? You bet. But they're also living longer.
 
 So do keep in mind - waiting to go on abx can lead to permanent lung damage and of course as everyone said this must be weighed with abx overuse. But it's important to understand the different schools of thought.
 
 But I personally know a few CFer's who do IV's 2x a year because orals don't work for them at a very very young age (2 years+). So this isn't unique.
 
 Think of every IV use as preserving lung function - a 2 week investment in the prolonging of your daughter's life <img src="i/expressions/face-icon-small-smile.gif" border="0">
 
 On a side note, I love nightwriter's philosophy of preventing colds. I had 5 (count 'em, 5) last year and none (knock on wood) this year and I'm pretty sure it's because I'm far more away of my hands touching my face. I know it's more difficult with a 3 year old, but I still think it's a great idea to keep in mind <img src="i/expressions/face-icon-small-smile.gif" border="0">

oral antibiotic resistence?

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