When I am healthy inhaler (Symbicort) daily and saline twice a week plus daily airway clearance work fine. If I get a cold or other illness I do saline daily, and sometimes have to add a Levalbuterol neb.
BUT, I do not have any evidence of MAC or pseudomonas at this time. My last exacerbation was Covid in September, the one before it was January 2023, so this is effective for me.