How to manage bronchiectasis and MAC disease in the elderly?

Question

Hello Doctor,

I am 62 years old and have had a chronic cough for the past year. A recent CT scan showed that I have bronchiectasis, and a sputum test came back positive for Mycobacterium avium complex. I am not immunocompromised, but my erythrocyte sedimentation rate (ESR) is 54 millimeters per hour, and my C-reactive protein level is 23 milligrams per liter. My doctor mentioned that this condition is more common in older women. Why does it affect women more often? Also, are three-drug treatment plans usually well tolerated in someone with a low body weight? I weigh 99 pounds.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Dealing with a persistent cough for so long must be exhausting. You are right, Mycobacterium avium complex lung disease is more common in women around this age, especially in those who are slender and do not smoke. While the exact reason is not fully understood, it may be due to a combination of factors, such as slight differences in airway structure, changes in the immune system after menopause, and long-term exposure to certain environmental factors.

As for the usual three-drug treatment, Azithromycin, Ethambutol, and Rifampin, it can be challenging, especially at a body weight of 99 pounds. These medications may cause side effects like nausea, loss of appetite, or fatigue, which can be more concerning in someone with a lower body weight.

However, do not lose hope. Treatment is initiated carefully, and you will be closely monitored with regular blood tests and vision checks. The doses will be adjusted according to your weight, and any side effects will be managed actively. Nutritional support is also essential. Many people do tolerate the treatment well when supported properly. We will go through this step by step together. Let us now discuss your specific concerns.

I hope you are satisfied with my answer. For further queries, you can consult me at iCliniq.

Thank you.