There is no doubt that indisciminate prescribing is the main cause of pseudomonas infection/colonistation in bronchiectasis. In the 50 odd years I have suffered from this disease I have had countless courses of blindly prescribed antibiotics. Too many GPs were only to happy to throw Amoxicillin, Penicillin, Co-amoxiclav and all the rest at us without determining whether the infection was sensitive to whatever bug you had. I am shocked to read that they are still at it depsite all the copious evidence and instructions to the contrary.
If you have bronchiectasis and you develop an acute infection, do NOT accept a prescription until a sputum culture is done and a suitable drug found. If like me, you have developed a colonisation of pseudomonas, it is probable that the infect will never be eradicated. At most it can be kept at bay and you out of hospital or at least out of long stay treatment. But bear in mind, pseudomonas is not the only infection out there waiting to infect the warm, moist soup that are the lungs of a bronch sufferer.
A lot of people don't realise that once they get to drugs such as Colomycin and Tobramycin, they are at the last chance motel, there aren't many more antibiotics out there.
I have always or almost always had to demand that a sputum culture is done because most GPs are simply not up to the job. However, when yo0u get pseudomonas, it's not going away and it is more or less pointless testing for it. That doesn't mean that testing shouldn't be done for other organisms of course.
I have read on here lately that there are still some clinicians out there who think it's acceptable to give patients a supply of antibiotics 'for emergencies'. This is blind prescribing and it will without doubt lead to serious consequences and I advise anyone who has been so prescribed to speak plainly to their GP OR specialist about it. NO ONE should take antibiotics with evidence that the organism is susceptible to the drug. The only way to find this out is by sputum culture. If you are seriously ill, you should be in hospital, not in the bathroom swallowing unspecified, powerful drugs.
There are also issues with side effects when using the 'last resort' drugs. Many if not all of them can cause ruptured tendons, thrush, bone disorders and many other serious and even life threatening conditions. Before taking any of these things, make sure you are told what side-effects are possible. Many of them have incidence rates of as high as 1 in 50! If they refuse to tell you or try to baffle you, you are NOT ins safe hands. I was prescribed a long term course of a drug called 'colobreathe' which is colomycin in a dry powder for inhalation. It was previously only licenced for treating young CF sufferers. Sad to say, I now have permanently inflammed tendons, asthma and an intractible, dry and painful cough and I am still infected with pseudomonas.
The internet is a truly wonderful thing, if you are given a drug and you have not be told ALL the facts about it, look it up and see for yourself. If you are concerned, tell your specialist and if he fobs you off, drop him and go looking for another one.
I am also quite shocked at the amount of people who are being prescribed ciprofloxacin blindly, this drug is another last resort one and must NEVER simply be handed out. It needs to be precribed at maximum dose under close supervision and ONLY if sputum cultures suggest that it is active against whateven infectio you have. NEVER, EVER accept cipro without a sputum culture or at a low dose, this will almost certainly expose you to pseudomonas.
None of us are receiving or have been receiving proper care, brochiectasis can be treated if found at an early stage but in later life it is permanent and degenerative. Be pro-active in your dealing with doctors, don't just blindly accept what you are told. Sorry if this sounds a bit negative but I get so angry when I read some of the upsetting cases on here, so much suffering could have been and could be avoided if only doctors would see our disease for what it is and not some off-shoot of bronchitis.