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Preliminary Guidelines for Adult Bronchiectasis

MAC & Bronchiectasis | Last Active: Oct 31 11:34am | Replies (21)
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@kathyjjb You’re welcome. I think it is a risk / benefit analysis. If you take the ‘drug holiday’ from the antibiotic that can be beneficial and the risk of a macrolide mutation with NTM isn’t as problematic, compared to the outcomes / risk of increased inflammation and exacerbations over time.

I also read an article or study recently that concluded that the outcomes of NTM Bronchiectasis patients isn’t that different from non NTM BE patients. The article stated that it could have an impact on the treatment discussions with BE patients with NTM. I’ll look for it to post.

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Replies to "@kathyjjb You’re welcome. I think it is a risk / benefit analysis. If you take the..."
jnmy | @jnmy | Oct 30 1:46pm

@kathyjjb

Here is the journal article I mentioned above.

The data is based on the US registry of Bronchiectasis patients and I think some researchers believe that people in the registry may have more severe symptoms.

Could that impact the results / conclusions?

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kathyjjb | @kathyjjb | Oct 30 2:46pm

@jnmy I'm not really surprised. I understand the risk/benefit. After being diagnosed with macrolide resistant M. Abscessus and told the cure rate is only 45% (25% with cavity disease), the risk to benefit quickly becomes meaningless. Not to mention the drugs needed from day 1-are much more toxic than azithromycin (though there are exceptions). I would like to see a study of BE participants without an NTM and taking the prophylactic macrolides and following the participants for 5 years. I think the solution, like "beclear" suggested would be monthly sputum cultures (if possible). Particularly for MABC that has a fast growth rate-so culture turn around can be very fast-depending on the lab. I would want to send to NJH lab and definitely discuss with my ID doctor. Thank you for bringing it up, I can see the benefit-particularly since I will not be using Brinsupri anytime soon.

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