Impact of Treatment on Long-Term Survival of Patients With Mycobacterium avium Complex Pulmonary Disease.

This article examines the impact of antimicrobial treatment duration on long-term survival in adult patients with Mycobacterium avium complex pulmonary disease (MAC-PD) treated at a tertiary referral center in South Korea from 2009 to 2020. Using time-varying multivariable Cox proportional hazards models adjusted for clinical factors, the study found that longer treatment durations, particularly treatment lasting 18 months or more, were significantly associated with reduced all-cause mortality. This association was especially pronounced in patients presenting with cavitary lung lesions or positive acid-fast bacilli (AFB) smears, indicators of high mycobacterial burden. The findings support current guidelines recommending active and prolonged antimicrobial therapy in progressive MAC-PD cases, while highlighting the need for personalized treatment duration based on disease severity.