Evaluation of the Efficacy of Multidrug Therapy in Patients With Mycobacterium Avium Complex Pulmonary Disease Diagnosed by Bronchoscopy

Abstract Rationale: Achieving negative sputum cultures through multidrug therapy has been reported to improve the prognosis of patients with Mycobacterium avium complex pulmonary disease (MAC-PD). However, evaluating the efficacy of multidrug therapy in patients diagnosed and monitored via bronchoscopy presents challenges due to the absence of sputum analysis. This study investigates whether bronchoscopy can be used to assess the efficacy of multidrug therapy in predicting respiratory events and survival prognosis in these patients. Methods: A retrospective analysis was conducted on 143 patients with MAC-PD who were diagnosed and followed up with bronchoscopy. Respiratory events were defined as hospitalizations due to hemoptysis, respiratory infections, or the development of chronic respiratory failure. Results: Among the patients, 45 were classified in the multidrug therapy group, while 98 were in the group without multidrug therapy. Although the multidrug therapy group had a lower median age and a lower proportion of males, there was no significant difference in BACES scores between the two groups. The BACES score is a system used to predict overall and respiratory-related mortality risks in patients with MAC-PD. Additionally, there were no significant differences in the incidence of respiratory events, mortality due to MAC-PD, or overall survival time between the two groups. Discussion and Conclusion: Patients with MAC-PD diagnosed and followed by bronchoscopy generally present with mild severity. In clinical follow-up, bronchoscopy could not distinguish the efficacy of treatments with and without multidrug therapy in predicting respiratory events or survival prognosis in these cases.