Gentamycin, Tobramycin Mupiricin and Amphotericin B. irrigation for sinus and asthma relief.

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 Gentamycin, Tobramycin Mupiricin and Amphotericin B.  irrigation for sinus and asthma  relief.

You’ve been irrigating you nose faithfully and yet you still have blockage to breathing, sinus pain, bad breath and snoring? If you also have asthma, the sinus infection is making it worse.  What should you do now?

Check the nasal cilia

Normally you have nasal cilia in your nose and chest that act like tiny paddles to move bacteria out of the nose.  This cilia movement keeps you healthy because the bacteria don’t stay in the nose or chest long enough to multiply and produce sinus or chest disease.

Irrigation is useful because you wash out some of the bacteria. The fewer the bacteria, the more opportunity for normal immunity to handle bacterial invaders. Pulsatile irrigation is best because pulsation action  is more effective in removing mucus, pollen and bacteria. The pulsing action resembles the expansion and contraction of your arteries from the beating heart, and acts like a massage, to move out stale lymphatic products and bring in fresh blood. When the pulsing action is tuned to the normal cilia movement, then that will restore good cilia activity; the pulsing action should be  “harmonious” to normal cilia beat movement.   Once the cilia recover normal cilia speed, then the body can defend itself.  Once cilia move normally, there is no need for more pulsatile irrigation; you don’t need the cilia to be more normal.

But there are conditions where even pulsatile irrigation at the “harmonius” rate of pulsation ideal for restoring cilia movement may not be sufficient.

o     The cilia may be impaired by excessive toxins

o     The mucus layer may be too thick to allow cilia to paddle away bacteria

o     Biofilm may be present. Biofilm is the presence of bacteria that have formed colonies and make shields that are impervious to antibiotics and simple flush.

Fewer Bacteria is best.

In all situations, reducing the bacterial count is the best first step.

         One approach is to add Xylitol to the Hydro Pulse saline solution.  Xylitol is a regular sugar used for tea and baking. Two teaspoons of Xylitol will make a 1% solution when added to the full Hydro Pulse basin.  Four teaspoons will make a two % solution.   The xylitol has two actions:

o     It makes it more difficult for bacteria to stick to the nasal/sinus tissues

o     Most bacteria can’t digest Xylitol

The advantages of using Xylitol are that you don’t build up bacterial resistance, there are no side effects, and at a cost of about five dollars a pound, the price is right.

Thick Mucus impairs cilia movement

In situations where the mucus is simply too thick, U of Penn researchers recommend adding one teaspoon of Johnson’s Baby Shampoo to the 500 cc of saline. This shampoo contains a product called surfactin, which acts to thin oily and sticky materials. The fact that it is safe for the baby’s eyes, reflects its safety for use with pulsatile irrigation in the nose.

Biofilm

Bacteria have learned to form colonies and create a gelatinous cover around the colony.  Generally, antibiotics can’t penetrate the gelatinous wall. The only effective remedy may be a concentrated antibiotic solution combined with  pulsatile irrigation, which acts to remove biofilm

Antibiotics by pass the stomach.

There are situations where the bacteria are well established in the sinuses. Normally, systemic antibiotics have difficulty reaching into the sinus cavities due to minimal circulation, and require prolonged courses of medication. Therefore, today doctors prefer to add the medication to the pulsatile irrigation; this delivers the antibiotic directly into the sinuses at a higher concentration than what can be achieved by oral medication.  Just like eye drops only affect the eye, medication by pulsatile irrigation only affect the nose and sinuses.  For many hospitalized asthmatic patients, a resolution of the sinus infection must take place in order the get the asthmatic well.  Therefore getting the antibiotic into the sinus cavity for stubborn sinus infections is imperative for asthma and allergy health.

How does the antibiotic enter the sinus cavity? When the stream that flows past the sinus opening is at a steady pressure and flow,  this creates a vacuum that pulls material out of the sinus.  When you use this steady stream  pulsing action, as the unwanted material is sucked out of the sinus, the pumping action pushes the saline solution into the sinuses. Then the sinuses fill up with the irrigation fluid that contains the medication.

It is convenient to culture the sinus material and then add the appropriate antibiotic to the pulsatile irrigation saline solution. Products such as Gentamycin,  Tobramycin, Mupiricin, and Amphotericin B, are commonly used.  A major advantage of administering antibiotics this way is that you can use drugs not usually used systemically.  Since they are not commonly used like Cipro, there is much less chance for antibiotic resistance.

If your doctor recommends delivering the antibiotic via the Hydro Pulse Nasal/Sinus Irrigator, often the directions are:

1.    Add 500 cc warm water to the irrigator basin

2.    Add one packet of Breathe.ease XL or one teaspoon of Kosher Salt

3.    Irrigate 300 cc each nostril.

4.    Stop and gently clear the nose to allow better contact with the medication.        

5.    Add the medication to the remaining 200 cc of saline

6.    Irrigate 100 cc on each side.

7.    After irrigation, remain quietly at the sink for 10 minutes. Don’t blow the nose for at least one hour.

It is always best to consult with your doctor about your best course of treatment.  On newsgroups I read of individuals recommending all kinds of products that are unproven.  You read where Mr. Jones used XYZ and now he is free of sinus disease.

Have you read the warm friendly advertisements: Mr. Smith sells  “miracle” Bora Bora Root that is harvested by virgins under a full moon, that will cure your sinuses.  Whether any of these products help the sinuses, one thing I notice.  All those happy smiling persons who use those products have bright shinny teeth.  So whether it helps the sinus or not, I wonder if maybe it helps the teeth?