TY - JOUR T1 - Outcomes of hypertonic saline inhalation as a treatment modality in nontuberculous mycobacterial pulmonary disease JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.02143-2018 VL - 54 IS - 1 SP - 1802143 AU - Anne Huiberts AU - Sanne M.H. Zweijpfenning AU - Lian J. Pennings AU - Martin J. Boeree AU - Jakko van Ingen AU - Cecile Magis-Escurra AU - Wouter Hoefsloot Y1 - 2019/07/01 UR - http://erj.ersjournals.com/content/54/1/1802143.abstract N2 - Treatment of nontuberculous mycobacterial pulmonary disease (NTM-PD) poses a challenge for clinicians and patients. Treatment involves 18–24 months of multidrug antibiotic therapy and has a cure rate of 50–70% [1]. Cure rates depend on the causative NTM species, drug susceptibility and disease manifestation; macrolide resistance and fibro-cavitary disease are risk factors for treatment failure. Even when treatment is considered successful, there is a high risk of recurrence, either by relapse or re-infection. Furthermore, adverse events, like gastrointestinal discomfort, are frequently seen and occasionally necessitate treatment discontinuation [1]. Management of underlying pulmonary disease is essential for successful NTM-PD treatment [1]. Since hypertonic saline (HS) inhalation is safe and has shown a clinical effect in bronchiectasis patients [2–4] we have included HS inhalation in our local NTM treatment protocol. In clinical practice, we advise patients with nodular-bronchiectatic disease to start with HS inhalation two times daily as the only therapy for the first 3 months. When patients tolerate HS and when there are no clinical signs of disease deterioration, we continue HS as the only treatment with close observation of possible disease progression. This clinical observation includes a high-resolution chest tomography, sputum or bronchoalveolar lavage mycobacterial cultures and pulmonary function tests.Patients with nontuberculous mycobacterial lung disease benefit from hypertonic saline inhalation http://bit.ly/2WQpYMz ER -