@happy2023 Let me preface this by saying I was treated for MAC in 2018 & 2019, but have been off antibiotics and my bronchiectasis stable for over 4 years. At first I did rigorous airway clearance with 7% saline twice a day, and was still having a lot of trouble controlling my asthma.

Over 2 years ago, my pulmonologist determined through testing, imaging and symptoms that my main issue is asthma and reactive airways, bronchiectasis is second, and other than some leftover artifacts, there appears to be no MAC. I was still having 2-3 exacerbations per year, and needing steroids and sometimes a short course of antibiotics.

She switched my asthma medication from levalbuterol (inhaled & nebulized) plus nebulized budosenide for attacks to a Symbicort inhaler (low dose budosenide plus formoterol) twice daily. I continued 7% saline and airway clearance once a day. After a year with NO exacerbations I was allowed to decrease the 7% saline nebs gradually - to about 2-3 times a week now, unless I have a respiratory bug - then it is upped to daily or twice daily. Through all, I have continued daily airway clearance with either vigorous exercise or my Aerobika.

I have now passed 16 months with no exacerbations, in spite of having 2 respiratory viruses in that time.

My story is not your story, but under certain conditions, it is possible to reduce saline use and be healthy. I am lucky that Mucinex and NAC allow me to keep my mucus thin enough to clear easily. But I will practice airway clearance for the rest of my life - I believe getting the mucus out reduces the places for the germs to breed.