December 9, 2022

Improving the antibiotic regimen for complex Mycobacterium avium lung infections

DRESHER, Pennsylvania. (WPVI) — We need bacteria to digest food and absorb nutrients.

However, when a bacteria commonly found in soil and water gets into our lungs, it can cause problems, in the form of a MAC infection.

Rick Tepper of Dresher, Pennsylvania has suffered from asthma, pneumonia and sinus infections for the past 15 years.

But three years ago, he noticed something different.

“Going up the stairs, getting more and more out of breath. The cough was there,” recalls Tepper, who is also a doctor.

His pulmonologist sent him for a CT scan.

“He looked at it and said – You know, I think you have a touch of MAC,” he says.

Laboratory tests confirmed the suspicions.

MAC is short for Mycobacterium avium complex.

“It’s just about everywhere, especially in soil and water,” says Temple Health pulmonologist Dr. Daniel Salerno.

He adds: “Most of the time it doesn’t cause any problems in human beings.”

But people like Tepper who have lung problems or those with weakened immune systems can develop a lung infection.

Dr. Salerno says the disease is often missed or misdiagnosed.

“Sometimes the symptoms are subtle. Sometimes the symptoms develop slowly over a period of months or years,” notes Dr. Salerno.

In addition to shortness of breath and chronic cough, MAC can cause chest pain or discomfort, mild fever, chronic fatigue, or unexplained weight loss.

Dr. Salerno says that if these persist, a doctor should check for MAC.

“The standard of care is to treat with three oral antibiotics for months, sometimes up to a year, sometimes up to two years,” he says.

However, side effects can make this difficult.

Tepper developed a fever and stomach issues before he found the right mix.


Dr. Salerno says Temple has two clinical trials aimed at reducing side effects.

One compares two antibiotics to the three standard drugs, while the other tests a new antibiotic taken alone.

Tepper says the treatment took time, but he paid off.

“You just have to wait,” he said with a smile.

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