other inhaled antibiotics?

R

rubyroselee

New member
Hi there,

Just wondering if there's anyone out there on any inhaled antibiotics other than Cayston, tobramycin/Tobi, or Colistin? I've seen some things online that there may be ceftazidime or amikacin available in the inhaled form? Just wondering if that's true and/or if anyone has ever been on it.

Thanks!
 
B

Beaz

Guest
My son has been doing inhaled Vancomycin off and on for a few years, but it is targeting MRSA, not pseudompnas.
 
N

nmw0615

New member
I'm also doing inhaled Vanco. It's a little difficult for me, since I have an allergy to it, but it seems to help my MRSA control. I just have to do extra albuterol with it.
 
T

triples15

Super Moderator
Good question Leah, I'm curious about this as well. I can not tolerate Tobi (bronchospasms), and had a terrible allergic reaction to Colistin a few years ago. That leaves Cayston as the only inhaled antibiotic in my "arsenal", which is scary.

I know a guy who has nebbed gentamycin for pseudo and had pretty good luck with that. So based on that and the prior responses, hopefully we have other options if it comes down to it!!

Autumn 34 w/CF
 
R

rubyroselee

New member
Autumn,

Same issue with me. Had to finally stop tobra due to bronchospasms as well. Colistin used to do the same thing to me years ago, but I just tried it again this month and I seem to be tolerating it ok. I also feel a bit freaked out about only having Cayston as my option since I know I will get sick as soon as I'm off any inhaled antibiotic. I remember gentamycin from when I was a kid, so wondering if that would still be an option at least. I think it's such an old drug that they just don't use it much anymore maybe? I know there are a couple new inhaled abx coming down the line, so hopefully those will be available soon!
 
S

sheilashera

New member
Hello. I am new but wanted to share what I am on. Started Tobi that did not seem to help my pseudomonas then my Dr started me on ciprofloxavin 90 mg. ciprofloxavin got rid of my pseudo !! It is not FDA approved but a pharmacy made a compound for me.
Good luck. Hope information helps.
Peace,
Sheila E
 
O

occupyjapan

New member
I've done the usual Tobi, Cayston, Colistin and Ceftazidime. Ceftazidime was great, but tasted like cat pee smells. Colistin makes my chest extremely tight pretty much the entire time I'm on it, but it goes away after a day or two off of it.

One that I've done that no one else I know has done is inhaled piperacillin/tazobactam (Zosyn). It tastes like road tar and made my sputum a weird color (I initially thought it was bleeding, but it turned out not to be; just some sort of chemical reaction when it mixes with sputum or something) but it worked REALLY well. I did 1000/125mg, twice a day.
 
A

Ank

New member
Dear buddy amikacin and tobi both r from same family..doc dont want to use it for inhalation bcoz they want to use it as iv injection..if u use amikacin for inhaltion u will develop resistance and will be in trouble .it is used as 2nd line of defence when you dnt respont to oral and inhaled antibioticlevofloxcin is under last stages of trial and i think it wil be ok. if u can get it use it.Colistin is also used i dnt prefer colistin its v toxic ..i will use it if none of antibiotic help me.Now i also want to tell you that last yr tobi killed me..and i switched to oral levo 500 mg with azithromycin 250 mg..from then my sputum culture does not show pseudoI advice you to eat a lot of protein it works better than any antibiotic ..also get ur iron checked ..mny cf ppl are iron deficient
 
O

occupyjapan

New member
Ank said:
Dear buddy amikacin and tobi both r from same family..doc dont want to use it for inhalation bcoz they want to use it as iv injection..if u use amikacin for inhaltion u will develop resistance and will be in trouble .it is used as 2nd line of defence when you dnt respont to oral and inhaled antibioticlevofloxcin is under last stages of trial and i think it wil be ok. if u can get it use it.Colistin is also used i dnt prefer colistin its v toxic ..i will use it if none of antibiotic help me.Now i also want to tell you that last yr tobi killed me..and i switched to oral levo 500 mg with azithromycin 250 mg..from then my sputum culture does not show pseudoI advice you to eat a lot of protein it works better than any antibiotic ..also get ur iron checked ..mny cf ppl are iron deficient
Click to expand...

"Dear buddy amikacin and tobi both r from same family"

Not really relevant. Germs can have resistance to specific antibiotics within the same family. Back when I still cultured pseudomonas, it was sensitive to gentamicin and tobramycin, but intermediate to amikacin.

"if u use amikacin for inhaltion u will develop resistance and will be in trouble "

That's a risk with any antibiotic, not just amikacin. Also, nebbing antibiotics drastically reduces the chance that you'll become resistant vs. IV or oral administration, since oral and IV administration results in a much lower lung concentration, meaning a resistant mutant could more easily arise. Nebbed administration results in sputum concentrations upwards of 100x MIC due to all of the antibiotic being deposited in your lungs.

"i dnt prefer colistin its v toxic "

It's only toxic if administered IV. Nebbing it drastically reduces the toxicity by limiting systemic exposure. It'll cause bronchospasms nebbed, but it won't fry your nerves or your kidneys that way. Even the IV toxicity is overstated and comes from old studies done in the 60's when they were giving massive, massive doses of IV colistin. It's more toxic than aminoglycosides (which are the drugs it was replaced by for serious gram negative infections), but it turns out that you also don't need as large of a dose to achieve similar efficacy, so it all evens out.

"I advice you to eat a lot of protein it works better than any antibiotic"

Wrong.

The next time you're sick with a CF exacerbation, stop all your antibiotics and just eat a bunch of protein. Tell us how that works out for you, if you live.
 
A

Ank

New member
@occupyjapan..:) thx 4 ur reply..In past i have developed resistance 4 tobi..as you know amikacin is given along with second antibiotic when u hv exceb..So if one inhale amikacin 4 long time sooner or later one wil develop resistancefor it..now if u have ever taken colistin u know how painful it us to take twice..i hv clearly written that i personaly dnt prefer it.. now about proteins..i jst meant protein boost helps a lot in fighting infection. my health has considerable improved by increasing protein in diet along with iron.. Earlier i was taking iv antibiotics monthly bt after increasing protein , got iron injected .and switched to oral levo from inhaled tobi..my culture went sterile..i dnt mean protein is replacment to antibiotic ..but it cn help.
 
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