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Dry Bronchiectasis and MAC—when to Treat
I have MAC and what I have heard termed as dry bronchiectasis. I have had it since 2014 with no treatment. I rarely cough and do not really have any symptoms—little or no fatigue, sputum, etc. However, I am told my scans are worsening and I may need treatment soon. I am 68 years old and in seeming good health apart from the MAC. Needless to say, I am scared to death of the side effects from treatment. For anyone in my position who has or has not started treatment, can you tell me how you are doing? If you started treatment, are you glad you did? Or do you regret it? Thank you.
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@juliea55 Welcome to Mayo Connect and to our MAC & Bronchiectasis support community.
Treatment standards and protocols for MAC have changed some in the past 10 years. There is now agreement amongst most of the highly specialized pulmonologists regarding when to begin treatment.
Here is an excellent PDF. Pages 11 - 15 are especially helpful regarding when and how to treat.
https://www.ntminfo.org/wp-content/uploads/2019/06/NTMSupplementalGuide.pdf
Even asymptomatic infections need treatment if the imbedded infection is destroying lung tissue.
Have you had a recent sputum culture or bronchoscopy to determine exactly what strain of MAC you have?
The good news is, now if you don't respond to the 3 antibiotic regimen within 6 months, another drug is added to clear the infection, instead of waiting for 18-24 month to make changes as was the practice in the past.
Finally, the side effects of the meds, while not pleasant, are manageable. There are dozens of people here who can offer tips for coping!
Sue
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3 ReactionsDry bronchiectasis is somewhat of an oxymoron to me. I may have considered myself with "dry bronchiectasis" before I started using a nebulizer with albuterol/levalbuterol followed by 7% saline. Then my dry bronchiectasis turned into productive bronchiectasis. @juliea55 if you have not already the first order of business should be airway clearance twice a day. Perhaps airway clearance will help you avoid the antibiotics and their associated side effects.
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2 ReactionsThank you, Sue, for the attachment. I will study it. Scoop, I do nebulize twice a day and use the Aerobika. I just rarely produce anything, but I am using 3 percent saline, as opposed to 7 percent. I have a good doctor at Mayo I trust, who I will discuss this with this week.
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3 ReactionsI have had mac & dry
Brochiectasis since 2010. I have never had treatment yet. I have only coughed up blood a few times in those years. But last August I had an exacerbation and coughed pure blood for about 60 hours off & on. They sent me for a pulminary embolization but were unable to get through. from a blockage. They wanted me to start antibiotics but I declined. Since then, I'm doing well. I have occasional fatigue and shortness of breath. Recently I ordered an aerobika and eclipse nebulizer. Have not started yet. I have a PFT in two weeks and an appointment with NJH in April. I am 70 yrs old and I will not do the antibiotics. My choice. Last ct scan it was mostly in my upper left lobe. Waiting on another CT in april. I totally understand your trepidation.
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