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MANAGEMENT OPTIONS Step 1: Diagnosis & Clinical Classification** ** Ref: 5. American Thoracic Society Documents: Mycobacterial Diseases Subcommittee. The Official Statement of the American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) Am J Respir Crit Care Med Vol 175. pp 367–416, 2007 ** Ref 9 Chitty S, Ali J. Mycobacterium Avium Complex Pulmonary Disease in immunecompetent patients. Southern Medical Journal June 2005, 98 (6) pp 646-652 Step 2: CATEGORIZE GROUP Surveillance Group Clinical and chest-imaging follow-up with serial sputum cultures and colony counts; ?also applicable in the “Hot Tub Lung Group” Treatment Group Suppressive treatment Group Based on risk-benefit analysis: Suppressive treatment with two drugs: ETHAMBUTOL & MACROLODE Aggressive treatment group FOCAL DISEASE 3 drugs +- SURGERY DIFFUSE NODULAR BRONCHIECTASIS 3 DRUGS THRICE WEEKLY FIBROCAVITARY DISEASE 3 DRUGS DAILY plus IV AMINOGLYCOSIDE Azithromycin, Ethambutol, Rifampin COMPLEX MACROLIDE RESISTANT CUSTOMIZED PROTOCOL J