Dan, I am an RT with > 20 yrs in the profession, more recently specializing in CF care. I know it is normally recommended to follow inhaled antibiotics with an inhaled corticosteroid in order to soothe the irritation which is probably present in all lungs after an inhaled antibiotic, but may become more pronounced over time with CF patients since they have such prolonged exposure to the inhaled antibiotics. Often times this is a combo inhaler like Advair or Symbicort. If you are having severe irritation, it might be worthwhile to switch to a different inhaled steroid, or to increase the dosage. Of course, if you do this, please be diligent in rinsing and gargling and spitting out the water after usage. I would recommend that you ask your doctor about a Pulmicort (Budesonide) inhaler and take 2-4 puffs after the antibiotic treatments. Or, if that has been tried, then maybe switch to a nebulized Budesonide. And, finally, if the irritation is severe during the treatment, try taking 2 puffs of the steroid before the antibiotic, and 2 after if you still feel your airways are irritated. Of course, do not try any of this without discussing it with your CF doctor/pulmonologist. And, as said, be diligent with your rinsing/gargling/spitting to avoid thrush. Some have to rinse with Nystatin on a regular basis due to their tendency to get thrush. Godspeed!
