Hi Terri. The two studies were designed for different purposes. As you know, the saline chart one studies concentrations of saline which allow different mycobacterium to survive. The bacteria along with various concentrations of saline were put in cultures and watched for 4 weeks. At the end of that period, the researchers tested to see which bacteria were alive.The best study for us would have been to test the saline concentrations on animals and then people or at the least on sputum. This study doesn't prove that nebulized saline treatment of any concentration kills bacteria in our lungs. I think most if us believe it does, but this study, which doesn't use patients, doesn't prove that.

The 0.9% v 6% study was conducted on two groups of people who do the same amount of airway clearance and was designed to discover if treatment with one concentration is superior to the other. It was not designed specifically for mycobacterium eradication through saline nebulization. Previous tests had shown that .9% was not effective with respect to cystic fibrosis bronchiectasis patients. This study was to see if the same results would occur with non cystic fibrosis bronchiectasis patients. The results proved that .9% is just as effective for non cf patients as 6%.

For those, like you, who tolerate 7%, this study is not important. For me, it is the best news wrt my airway clearance treatment that I could have.

Stay safe! Rita

National Jewish also recommends 7% saline twice a day for our lung disease.. I have read the same info on many sites saying the same thing..I sometimes can’t tolerate the second dose, so I will use 3% instead with my Colistin..thanks for th3 info Terry

Hi Aunt Nanny… I too have pseudomonas and am using Colistin every other month.. Toby made me wheezy and cough a lot… this drug is amazing and has changed my life along with proper airway clearance and 7 percent saline twice a day

@marellen From my understanding, the antibiotics are to treat the NTM, (MAC, MAI, etc.). The saline thru the nebulizer is to assist with lung clearance and in making the lungs less hospitable to various mycobacterium infections. Very important for those of us with bronchiectasis. I think most, if not all, on this forum do some type of lung clearance daily. Hope that helps a bit. Others on here are much more knowledgeable regarding this than I am.

I have not been diagnosed with a MAC/ntm’s yet. He is hoping the vest/albuterol/7%saline is helping…..so far, so good…..but I don’t know what he would do if those infections showed up.

Another note in support of 7% saline in my nebulizer – I was on the Big 3 for 6 months before I had side effects (tinnitus and hearing loss). I was referred by my GP to a MAC specialist as my respirologist, who had an abundance of confidence but little knowledge of MAC, would not refer me.

The specialist took me off the Big 3 and started me on 7% saline with Aerobika and chest pummeling (my gracious husband was taught to do this). My bacteria count went from 3+ (out of 4) when I stopped the Big 3 to 1 in 4 months and I will do a forced sputum test next time I go in.

Anyway, my point is that the saline has enabled me to stay off medications for 9 months and my overall health has improved so hopefully I can maintain this. Perhaps things would have gone better for me on the medications if I had done both at the same time.

I wouldn’t advocate stopping medications but I completely support the use of saline and other measures to support good health with them (or without, if that works).

I am so thankful to members of this forum for all the helpful information that I’ve received, including learning to do our own research and to be strong advocates for ourselves.

Hi all, I noticed that the study did not look for MAC or NTM in their patients, only other types of bacteria ("At baseline 60% of the participants in the IS group and 55% in the HTS group had a positive sputum culture for Pseudomonas, Haemophilus, Aspergillus, Staphylococcus aureus or Streptococcus with no significant difference in isolates between groups.") We don't know whether any of the participants had MAC. For those of us with MAC, as well as bronchiectasis, the study @windwalker (Terri) and @alleycatkate (Kate) posted (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4850692/) suggests that 7% would be necessary to keep MAC under control.

Hi again, I hadn't read @windwalker Terri's comments on MAC when I posted the comment above. I completely agree with her comments!

Thanks for your reply. The study is only meaningful for those of us who cannot tolerate 7% or, in my case, 3% as well. It tells m, and anyone else with inflamed, delicate airways that using .9% is not a waste of time.

@rits Thanks for posting the study. It's greatly appreciated! Yes, it's important to see that using .9% is not a waste of time for airway clearance for those who can't tolerate 3 or 7%. (When I posted my comment, I was just worried that those who had MAC and could tolerate 7% might think 0.9% would control the MAC.)

Hello, folks ! Ok…. I have been reading these posts and educating myself as I go along. Question. Does anyone out there who has MAC and bronchiectasis NOT use saline nebulizing as part of their treatment? I ask because this part of therapy has never been mentioned to me and from what I'm reading, nebulizing seems to be an important addition to plan wellness. Am I missing something?? Also I have been on the BIG3 since Jan 2019. Knock on wood so far I'm tolerating it well. However, I did start to experience some tinnitus ( ringing and whooshing in my left ear). When I mentioned this to my ID doctor's nurse and she "checked with the doctor", I was told " Dr. said that it couldn't be the meds, it must be something else." Yet, I've read over and over MAC patients on these antibiotics do most likely at some time develop tinnitus. I really like this doctor but I'm getting "concerned" that she may not be that learned in MAC/Bonchiectasis. I'd appreciate y'alls input. Thank you !

@toni1132 I will comment on the tinnitus first. Go with your gut. Without bring disrespectful towards any physician, what you said about that doctor is probably accurate. Some doctors are way more knowledgeable than others about MAC and Bronchiectasis. As far as nebulizing saline I have found that the majority of the members on this site do very beneficial daily airway clearance in one form or another. Another extremely important thing I have learned is that we need to advocate for ourselves with this disease. irene5