Considering treatment for M. Abscessus

Posted by cattleya @cattleya, Oct 14, 2024

Hi. My doctor is recommending antibiotic treatment for M. Abscessus as I have had 3 positive sputums. I feel pretty good though. Some coughing at night, throat clearing, but able to walk 2 miles 4x/week, use treadmill and elliptical at gym and play pickleball 2x/week. I do get winded walking up hills and have trouble walking and talking. I have to pace myself at pickleball. I'm 76 and afraid of side effects and destroying quality of life if going on these meds. I'm VERY medication sensitive, can't tolerate most antibiotics for 10 days even. I've had terrible, months long reactions to Covid vaccines (had 5 of them) but did well when I got Covid in September (17months after last booster). I'm also worried about ability to function while on these meds since I take care of the household, do all the shopping, cooking, cleaning, finances and take care of my 80 year old husband. I'm interested in hearing from anyone who has gone through the treatment and learning from their experience and would really appreciate your response. I also hope that you are doing well.

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kathyjjb | @kathyjjb | 17 hours ago

Hi, I'm looking for info on which antibiotics combination are currently being used for MAC Abscessus. Any successes? I had my first appointment with an ID doctor and she told me she would put me on Tetracycline, Inhaled Amakacin, and one that starts with "R". I just read a study that says MAC A. has a Tetracycline resistance 500 times more than macrolides-which abscessus is resistant to. I have an appointment at NJH but it's not until the end of May and I just got slammed with something. My middle and lower lungs ache, coughing up green sputum. I'm wondering is this the MAC rearing or maybe I have a secondary infection. So now, contacting ID doctor to possibly start treatment. I'd like to have more info on what is generally used before I talk with the ID doc. Thank you!

pacathy | @pacathy | 11 hours ago

I don’t have MAC, just mild bronchiectasis and have not experience with treatment, but will bump it up for you.

I found these guidelines from 2020 from the ID Society. There was a big meeting on bronchiectasis in last month and updated recordings should be available soon.
https://www.idsociety.org/practice-guideline/nontuberculous-mycobacterial-ntm-diseases/#FullRecommendationsforSpecificPICOQuestions
Scroll to XIX for treatment of abcessus. . It’ll give you a start.

You could check the lab portal. They generally do sensitivities on the sputum you sent. That might be why doc is ordering something unusual. Speaking of sputum, have you sent a new one since you started feeling bad. Ask ID doc or your pulmonologist about doing that if you don’t have a standby order. I’d contact soon.

I hope you get help soon.