What is the Mayo Protocol?

Several patients are following this regimen, often with good results. You might like to ask your doctor about trying this, or perhaps they will suggest it to you.

 

The protocol involves taking three drugs:

• Trimethoprim/Sulfamethoxazole (Bactrim/Septra/Co-Trimoxazole) – a sulpha based antibiotic – just small doses regularly. This potentially kills any bacteria in your away – patients with a stenosis tend to often have bacterial infections which build up behind their scarring, causing thickened mucus and the risk of plugs.

• A steroid inhaler – such as Qvar, Pulmicort or Flovent – one inhale per day. This reduces inflammation in your airway.

• Protein pump inhibitors/Acid reflux medicine – such as Prilosec or Nexium once a day. If you have reflux, then this can potentially reduce inflammation in your airway and prevent damage to the skin there from stomach acid.

 

What are the risks with this protocol?

As with all drugs, these can have side effects.

• Antibiotics:  Some people can have negative side effects with taking antibiotics long term, such as thrush and stomach issues. Some people cannot tolerate sulpha based drugs, in which case an alternative is found.

• Steroid inhaler: This can cause oral thrush – you need to wash your mouth out and gargle with water after you take your breath. Some people can find the powder will coat their vocal cords (another reason to gargle), causing a husky or raspy voice

• Protein Pump Inhibitors/acid reflux medicine – if taken long term can potentially cause kidney problems and brittle bones. Recent research suggests PPIs do not have an impact on patients’ airways where there is no evidence of GERD. A gentler medication such as Gaviscon may be better in this situation.

 

What are the benefits with this protocol?

Those patients who have had success while following this protocol have reported:

• Lasting longer between dilations

• Less inflammation, therefore improved breathing

• Less thickened mucus, therefore reduced coughing, and improved breathing

 

There is no evidence that this stops the scarring, rather it tends to treat the added symptoms surrounding it.