@capletcher Not @thumperguy here, but let's talk about why the long-term antibiotics are prescribed for MAC.
When I started therapy almost 8 years ago, and gasped when the doc told me how long I would need the meds, he explained "MAC is slow to grow and slow to go..." He explained that a single negative culture is not definitive, and stopping at that point nearly guarantees the infection will return.

A little history - my first negative cultures did not come until more than a year on antibiotics, and by that time I was taking them daily. Back in 2019, Amikacin/Arikayce for stubborn infections was still in clinical trials, so they just upped the dosage of the "Big 3." And the usefulness of 7% saline was still being debated, so I was using levalbuterol and 0.9% saline. In about October 2019, I switched to 7% saline, had my first negative culture, and was thoroughly miserable from the daily meds.

In December, my ID doc (consulting with my pulmonologist) consented to stopping the antibiotics and just continuing 7% saline and airway clearance.
For the next 2-3 years, I nebbed 7% twice a day and recovered from antibiotics. Since then, I have negative cultures and stable CT scans, and have gradually reduced saline nebs to a few times a week with airway clearance every day. I also got my asthma under control.

The bottom line? In 2026, doctors very experienced with MAC are sometimes more willing to "watch and wait" before using antibiotics. This isn't passive, it includes daily airway clearance (usually with 7% saline) and regular monitoring with sputum cultures and CT scans. This is only a possibility IF you do not have extensive infection heavy bacterial load, cavities or large nodules in your lungs, and have few/mild symptoms like weight loss, cough and fatigue. If I ever test positive again, my doctors and I will consider all these factors before deciding on a course of treatment.

Are you under the care of someone experienced with MAC and Bronchiectasis?