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@heathert

@anniepie I had no idea that the susceptibility test was not great, surely they could do some longer term biofilm testing on Intracellulare. I was on the big 3 for 3 years, 3x weekly and 2 years daily (the last year with Arakrice) before it finally stopped doing damage in my lungs. It can be long haul. Take care Heather

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Replies to "@anniepie I had no idea that the susceptibility test was not great, surely they could do..."

Me too Heather -- I wish that also.

Most drugs fighting all kinds of bacteria are petri-dish-tested using mainly the planktonic ('free- floating') stage of bacteria, not really testing much sessile bacteria living inside biofilms. The drug companies do that to show their drugs work. (They would need drug doses far far higher to fight through biofilm to get to the bacteria, and nobody can survive that).

Some NTM drugs do manage to get into the outer layers of the biofilm though -- just not into the inner bacteria in biofilm. (Azithromycin is one that can do this a bit -- at least for a while). So it's no wonder the drugs can take such a long time trying to kill this bug.

Unfortunately our lungs a rather delicate things -- we can't treat them like "old leather bags" as many people do when we're young! While our stomachs can handle vinegar and things like that, our lungs cannot. (Neat vinegar kills mycobacteria, folks!). But even inhaling vinegar gas into our lungs can cause severe damage to our lungs, unfortunately. The lungs are a difficult place to treat bugs.
And it's very difficult to find things that break up biofilms in the lungs that are also safe to use in the lungs.

Some people, with cystc fibrosis for example, have tried nebulising drops of essential oits that are meant to be antimicrobial and fight biofilm. But then they can develop severe hypersensitivity reactions to them in their lungs, and can't use them again. Some other people have started using sound vibrations on their chests (some sound vibrations are used to help prevent biofilms from developing on surgical equipment). But it's difficult and I wish there was much, much more research on mycobacteria treatments and biocides for biofilms that are safe to use in the lungs. We all do.