1st PA Culture, which treatment would you do?

[rcq925]

I also posted this in the Family section, but I am posting it here as well!


My daughter, Hayley, who is 2½ just cultured PA for the first time! I am devistated. I knew the day would come when she would culture it, but I just hoped and prayed that it would be years down the road!

SO I am waiting to hear back from the doctor, what he wants to do treatment wise. I know a lot of people do the oral Cipro and the inhaled Tobi and do erradicate it. But I also know some do the IV meds and then the Cipro and Tobi. I want to be VERY agressive and erradicate the PA, so I am just wondering what others have done as far as treating PS in their small children and which way is the best way to erradicate it?

 

[thelizardqueen]

This is just me, but I would first try the Cipro and TOBI. I guess it was just the way I was brought up, that you try the cipro and TOBI before you do IV. But then again I don't think inhaled Tobra was around till I was about 14 I think give or take.

 

[NoExcuses]

i would push for IV Tobra ASAP.

Your goal is to eradicate the PA - and make sure that it is 100% gone. IV's are much more effective for this.

 

[blackchameleon]

Gday there Becky, my two bobs worth is hit the PA with the big guns
up front! when i first contacted PA years ago i was given orals
first. this didn't eradicate the PA and iv's were called upon. by
this stage the PA had colonised and form a decent little army!! i
treat CF like tactical warfare i think and believe in no half a**ed
measures. the catch 22 is that i feel it is also wise to stay
away from hospitals as much as possible -- thats like jumping into
the enemy's camp, however at 35 i need to go to hospital regularly
now and just keep my distance from others with CF and peoples in
general with chestus buggeredus!! like i said , tactical warfare
but u yanks r pretty good at agressive approaches! (tongue in cheek
guys ) BChameleon. ps let us know what u dedcide, its
interesting. 

 

[rcq925]

Thanks Liz, Amy, and black chemelon for your replies. I appreciate it. I did talk with our doctor and at first he wanted to do the oral Cipro, however, I told him I wanted to be as aggressive as possible and eradicate the PA, and he agreed to do the IV's, so we are being admitted tomorrow morning at 8am to start IV's. Not sure what drugs we are doing yet, but I really feel that this is the best course of action.

Amy, Can you please explain to me why the IV's are better at eradication than the orals? I believe you are right which is why I pushed for the IV's, but would just like to know exactly why, because they are stronger? Because they reach the lungs more quickly? Thanks in advance!

 

[NoExcuses]

Tobramycin as an antibiotic is much stronger against PA than Cipro is. And tobra doesn't come in oral form. It does come in nebulized form but the TOBI doesn't always reach the site of infection because the site can be blocked by mucus.

 

[wuffles]

*edit* Oops, didn't read your second response! Good luck with the IVs and I hope you get rid of the nasty little bugger!*

Did the doctor do a test to see which antibiotics it is sensitive to? If they are sensitive to cipro then I would definitely go the oral cipro with inhaled tobramycin first off. I know when I get put on both cipro and tobi, it works almost immediately. It never eradicates it totally for me but that might be because I was never treated very aggressively as a child.