To go back to your initial question, a few people on this group have taken very-long-term antibiotic therapy because their infections never seemed to be controlled. Maybe some like Terri @windwalker can explain.

If repeated antibiotic treatment over 4-5 months has been needed, it suggests that the drugs are not curing your infection, just knocking it down temporarily. The danger with this cycle is that the germs will just become more and more resistant to the short term drugs being used.

In general, though, if your infection is MAC flaring up, you may need to go back on the Big 3 and possibly something supplemental like Arikayce...this is something to discuss with Dr McClain at Mayo, unless your local doc is skilled in treating MAC. Your test results on the Mayo Patient Portal should show what was tested.

Here is a technique that has worked for some of us to help keep infections (and for some of us, even MAC, under control) - an "amped up" version of airway clearance, using Mucinex, NAC or glutathione to help thin the mucus, combined with 7% saline nebs to help clear out the airways. There is some evidence that the 7% saline also helps suppress the growth of MAC. Then airway clearance. At first I nebbed twice a day, then after months of little mucus, my pulmonologist suggested once was okay, just increase at the first sign of problems. I have now been antibiotic-free for 3 years!

And I made it "almost" all the way through 2023 without an exacerbation - got a respiratory virus recently that kicked off my dreaded cough, so I doubled down on my nebs & airway clearance for a few days. At first the mucus I was bringing up from way deep was dark yellow and very thick, but yesterday it converted to clear & much thinner, and my cough has receded from painful & frequent to just annoying. I follow my first neb with a vigorous walk in the cold that brings up even more stuff. Yoga poses also work when I won't go outside.

What is your airway clearance routine like?
Sue