← Return to Taking other medications in addition to antibiotics for NTN

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Profile picture for Sue, Volunteer Mentor @sueinmn

@lvnl & @kathyjjb There are numerous protocols for treatment. Some use 2 drugs (often based on sensitivity testing), some adding Arikayce or another drug right away. The decision between 7-day and 3-day dosing may be made based on severity of the infection, or what strain of NTM is being treated.

The usual protocol for beginning antibiotic treatment for MAC has been 3 times weekly for many years. My personal observation is that some ID docs not working in conjunction with a MAC-knowledgeable pulmonologist are more likely prescribe daily meds. I'm not sure why this is the case, but sometimes when that person gets to an expert pulmonologist, the dosage is cut back to 3 times a week.

If you want to see the published protocol from 2020, look at the table on page 20 of this document:
https://ntminfo.org/wp-content/uploads/2020/07/NTMguidelines2020.pdf
New guidelines are coming, here is a preview that has not yet been published for the US:
https://www.atsjournals.org/doi/full/10.1513/AnnalsATS.202408-904FR
It says, in part, "For less severe noncavitary NB disease, a thrice-weekly regimen is often adopted for its effectiveness and better tolerability than daily treatment."

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Replies to "@lvnl & @kathyjjb There are numerous protocols for treatment. Some use 2 drugs (often based on..."

@sueinmn The article from the ATS Journal is very interesting. It may be the solution to my dilemma for wanting to take low dose macrolides during flu season due to frequent BE exacerbations. Brensocatib is not an option for me. The recommendation is that low dose Erythromycin be used since "it has no activity against MAC (didn't mention MABC) and shouldn't result in macrolide resistance". I also see that some of Charles Daley's publications were referenced in the article, so fairly certain my NJH ID doctor is up to speed on all of this. Thanks for posting!