For me, I decided not to take azithromycin even though I was in the camp of frequent exacerbations. I found that lung clearance 2x day (levalbuterol or albuterol inhaler & 7% saline) was enough to keep the bugs at bay and diminish the frequent infections. My reasoning was to save antibiotics for when I needed them and not to take prophylactically.

Having bronchiectasis makes us prone to various pathogens including MAC/NTM. Azithromycin is one of the mainstays of treatment for MAC. My chances for contracting MAC are not zero, which means I might need azithromycin someday. We're all different and need to make these decisions with our doctors. Thought I'd share an opposing view in case that helps anyone.