When you are first diagnosed, some wonder about the side effects of the antibiotics used to treat the infection. Should they commence treatment or wait and see what happens. Yes some people can and do continue an active life without treatment for many years. Eventually the infection does gradually slow them down. Treatment becomes the only way to regain your health.

If you have cavities in your lungs or you have been coughing up blood or have lost weight, then it is usually recommended that you get treatment straight away, as these are signs of advanced infection.

If you have a milder form of ‘Nodular Bronchiectasis’ – that is a combination of small nodules and dilated +/- inflamed airways seen on CT scan, then sometimes your own immune system can get the infection under control, and you may not need treatment. If your doctor recommends a period of observation, then they are giving your body the opportunity to heal naturally. If however, your immune system is not strong enough, or the infection is too strong, then treatment may be indicated. If your doctor decides not to treat you straight away then it is important to have regular follow-up- so that if things don’t progress well, you can be treated before more damage occurs in your lungs.

Bronchiectasis is a sign of permanent damage to your lungs and can be associated with bleeding, called haemoptysis. In rare cases this can lead to major bleeding of the lungs, called a pulmonary haemorrhage. This is even more important, if you are taking blood thinners. Treatment will help minimize any further damage to the lungs and reduce this risk.

Yes, the side effects of the antibiotics can present their challenges. It is quite rare for a competent and experienced doctor not to be able to manage the problems as they occur. It is important in the first months of treatment to have a good line of communication with your specialist to trouble shoot any problems you may encounter, so that the best combination of medications for you is worked out early.

Many people are NOT affected by the drugs and are treated successfully. Many feel so much better after starting treatment that they wonder what the fuss was about. However some people do have side effects that need to be worked through. Yes, you may become fatigued and have problems with your stomach that you will need to live with, whilst you are being treated. They can be unpleasant, but it is possible to live with these difficulties, to regain your health.

If you decide NOT to be treated, it is even more vital that you clear your airways every day. The bacteria can continue to multiply and populate your lungs, leading to more mucus plugging your airways and breathing problems. Eventually the bacteria may win. It is always best to listen carefully to your doctor’s advice. The earlier you begin treatment, the better.

Yes, the decision to be treated or not can be very difficult. From a medical point of view the following paper authored by Dr Thomson and Wing-Wai Yew, although written for medical professionals can give you an insight to your Doctors dilemmas.  This is an excellent paper and well worth a read, Start on Page 3

When it is agreed to treat the infection, most doctors follow the advice of the American Thoracic Society treatment guidelines. If you happen to be interested, here is the link to the American Thoracic Society about NTM.

Useful links on NTM treatment:

You will also find good information about the Treatment of NTM in the NTM Info & Research pamphlet “Insight” . you can download a copy from

Question & Answers from NTM Info & Research

There is also excellent information about the treatment of NTM in the book called

The NTM Handbook

“A Guide  for Patients with Nontuberculosis Mycobacterial Infections including ‘MAC”

You can download a copy from the author for US$ 20.00 at

Many people find understanding from other patients from within NTM forums who have confronted the dilemma of “being treated or not”.


Yes, after treatment it is not uncommon to be reinfected.

Some people go to a lot of trouble to minimize their exposure to the bacteria in the environment. There is lot of useful information in the NTM Info & Research Q & A (link above).

Irrespective of whatever action you take to avoid exposure to the bacteria, you will still be dependent upon your immune system to minimize the growth and multiplication of the bacteria in your lungs. It is vital at all times to exercise and eat healthy foods.

If you would like to know more about the drugs used to treat MAC..see

 Tip: If you have difficulties when swallowing your medication pills, put the pill on your tongue, put some water in your mouth, move your chin down to touch your chest without any force, and swallow.