This question was recently asked at a BNTM Coffee Social.

Katie: Your doctor may want to monitor you if you are not symptomatic since the antibiotics themselves may present great side effects.

Christina: The decision to start treatment is preferred yet depends on several factors, whether the NTM is causing damage to the lungs, advantages/possible risks of therapy, a person’s wish to start treatment after discussing it with their doctor, and the goals of treatment. Some physicians may choose to watch and wait to see if the patient becomes symptomatic as Katie mentioned above.* I would weigh all options.

John: Starting airway clearance may be a good way of reducing the effect of your MAC and preventing it from getting worse.

*Reference: Daley CL, Iaccarino JM, Lange C, et al. Treatment of nontuberculous mycobacterial pulmonary disease: an official ATS/ERS/ESCMID/IDSA clinical practice guideline. Eur Respir J. 2020;56(1):2000535. Published 2020 Jul 7. doi:10.1183/13993003.00535-2020