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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should Tobi be stopped while suffering from apnea?

My wife is taking tobramycin nebulized 2xper day, 28 days on 28 days off with azithromycin taken prophylactically between. She has MS and is taking it to combat colonized pseudomonas infection. Has worked well for over a year. Last month after quitting she started suffering sudden attacks of apnea, not sleep apnea but wide awake, not brought on by low oxygen. This occurred many times but lasted about one day then ceased for the rest of the month. 4 days ago, a few hours after resuming tobi this month the apnea events returned. Should I ask her doctor to return to azithromycin? Should I stop tobi immediately?
Tue, 17 Jul 2018
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Pulmonologist 's  Response
Hello and Welcome to ‘Ask A Doctor’ service.
I have reviewed your query and here is my advice.

Yes, you should definitely restart Azithromycin.
By your history and description, she is suffering from chronic lung infection. Once she stopped antibiotics, her symptoms appear again.
So better to continue Tobramycin via Nebulization and Azithromycin via oral route.
Now a days it is studied and accepted to give life long Azithromycin in chronic lung infection. This certainly prevent exacerbation. So you should definitely start Azithromycin in her case.

Hope I have answered your query.
Let me know if I can assist you further.
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