@nnassiri Hello Nass - I am glad to hear that your wife is seeing improvement and tolerating the medications. The usual duration of treatment for the Big 3 antibiotics is somewhere between one and two years, but it is highly variable. I do not know if there is clinical evidence that 3-4 years of continuous treatment is effective, and I would be worried about the long-term effects on the body of so much medication and development of drug resistance. Has her team submitted the sputum culture to drug sensitivity testing to be sure the strain of NTM is susceptible to the drugs being used? One of our members, Terri @windwalker has used Tobramycin and another drug in alternate months to keep her infection under control - maybe she can tell you something about how that is working for her.
Sue

nnassiri, Hello. Is your name Nass? I want to give you additional information on treating mac. If you click on my photo icon here; my treatment plan will pop up. You are right to ask about a longer treatment period with antibiotics. I have been on monthly antibiotics since 2013. I was tested mac negative by 2014, but stayed on the drugs to keep it gone. Then, in 2016, I got infected with pseudomonas. I was then prescribed inhaled tobramycin 300 mg. That knocked the pseudo out in 30 days. I have been on bi-monthly antibiotics ever since then. I have been infection free since 2016. I am treated by drs at the Mayo Clinic. They have the best reputation in the world. I was never put on the 'Big 3' antibiotics, and was fortunate that my treatment worked. Did your wife's doctor also have a suseptibility test done? If yes, please get a hard copy of it. If you do not mind sharing the results; I'd like to know what the results are. This is important. The bottom line is; whatever caused your wife to be vunerable to mycobacterium infection, never goes away. That is why patients should consider long-term antibiotic maintenance. Blessings to you & your spouse.