Cleaning and Disinfecting Nebulizers

Reviewed by: HU Medical Review Board | Last reviewed: September 2019

Because nebulizers are used daily to deliver medicines deep into the lungs, keeping them clean and sterilized is one of the most important infection prevention methods for people with cystic fibrosis (CF). Unclean nebulizers offer an excellent environment for the germs that cause lung infections. Keeping your nebulizers clean and disinfected prevents cross-infection and re-infection, which helps preserve lung function. The processes used to clean and disinfect nebulizers depends on the type or brand being used.1

Disposable nebulizers

Disposable nebulizers are made of plastic that cannot withstand heat cleaning methods or multiple uses. When it comes to using disposable nebulizers the following tips are important to know. You should wash your hands before using them. They should be thrown away after 24 hours. You should use single-dose vials of medication whenever possible with disposable nebulizers.1

Reusable nebulizers

Reusable nebulizers are sturdy enough for multiple treatments over weeks and months. However, to be reused, this equipment must be thoroughly cleaned and disinfected or the germs that cause lung infections can grow.

4 steps for nebulizer cleaning

  1. Clean: Wash your hands, then wash all nebulizer parts in a clean basin with dish detergent. Use a paper towel to scrub the parts and then toss the towel in the trash. Rinse off the soap.
  2. Disinfect: There are two methods to disinfect your nebulizer: heat methods and cold methods. The method you use depends on the manufacturer’s recommendations and the CF Foundation’s best practices.
    1. Heat methods
      • Boil for 5 minutes at a rolling boil.
      • Microwave for 5 minutes, submerged in sterile water in a microwaveable bowl.
      • Dishwasher, if your dishwasher remains at 158 degrees Fahrenheit for at least 30 minutes.
      • Electric steam sterilizer. These are baby bottle sterilizers with a 6-8 minute steam cycle.
    2. Cold methods
      • Soak in 70%-90% isopropyl alcohol for 3-5 minutes.
      • Soak in 3% hydrogen peroxide for 30 minutes.
  3. Rinse: You must rinse your nebulizer after using any cold method to get the disinfectant off the parts.
  4. Air dry: Lay the nebulizer parts on a clean paper towel to air dry. If the paper towels get damp, move the parts to new, dry paper towels.

Electronic nebulizers

Electronic nebulizers should be cleaned and disinfected after each use, just like other types of nebulizers. The most common brands are Altera® or eFlow®. The manufacturer directions may vary, but generally, these nebulizers are cleaned using an electric steam sterilizer (baby bottle sterilizer).

The steps to clean an electronic nebulizer

  1. Wash your hands (Be careful not to touch the metal membrane of the aerosol head at any time in the cleaning or place it head down while drying)
  2. Rinse the nebulizer parts under warm running water
  3. Wash the parts in a bowl of warm water and a few drops of dish soap
  4. Rinse the parts in warm running water and place on a clean, dry, lint-free towel or paper towel
  5. Use a steam sterilizer to disinfect the nebulizer parts
  6. Air-dry the parts on a clean lint-free towel or paper towel

Air drying is recommended for all nebulizer parts. Lint from paper towels or cloths can be inadvertently inhaled with the medications.

Do not use antimicrobial soap or white dish soap because these might damage some of the parts. Do not use a microwave steam sterilizer because this type of nebulizer has metal parts.

Additional tips for cleaning and sterilizing nebulizers

  • Always clean your hands before handling your nebulizer and make sure the environment in which you are using the nebulizer and sterilizing it are clean
  • Do not reuse alcohol or hydrogen peroxide from a cold cleaning
  • Do not use tap water to clean nebulizers. You can buy sterile water in bottles or make your own by boiling tap water for 5 minutes
  • Nebulizers with metal parts should not be sterilized in the microwave
  • Have as many nebulizers on hand as you have inhaled medications. That way you can move from one medication to the next without having to clean one nebulizer over and over
  • If you are using multiple nebulizers at once, rinse each nebulizer immediately after each treatment. When medication dries it is harder to clean out
  • Do not store a wet nebulizer to prevent mold or germs from growing on the parts1-3

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