Patient description: Patient A is a 30-year-old male who was admitted to the hospital after 10 days of cough, profuse nocturnal sweating and loss of appetite. He had traveled to India 1 months ago and has not any positive history of TB vaccination. He is a previously healthy man, working as an engineer in a high tech company. He doesn't smoke o use any illicit drugs. He was febrile (38 c) with heart rate of 115 b/min, respiratory rate of 22, BP of 125/75 mmHg and O2 sat of 97%. Chest X-ray showed infiltrate in the middle of left lung with diameter of 1.8 cm with signs of cavitation. The sputum smear revealed positive sputum culture for Mycobacterium tuberculosis which are sensitive of the first-line TB drugs (isoniazid, streptomycin, rifampicin and ethambutol). Lab study is reported bellow: Hgb: 13 g/dl WBC: 14000 /mm3 Plt: 300000 /ml AST: 13 U/L ALT: 15 U/L Alk P: 53 U/L Bill total: 0.6 mg/dl Na: 137 mEq/l K: 4 mEq/l Creatinine: 0.5 mg/dl BUN: 10 mg/dl ESR: 120 mm/hr

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Mycobacterium Avium Complex Has a diagnosis of NTM-PD due to MAC Had at least 1 prior positive culture (sputum or bronchoalveolar lavage) positive for MAC in the previous 6 months Has an induced sputum culture at screening positive for MAC by at least one of the following methods performed by the microbiology laboratory: quantitative culture on solid agar or growth on liquid media (MGIT) Is either treatment naïve and has not received any prior treatment for MAC, OR if previously treated for MAC, has culture evidence of persistent, recurrent, or relapsed disease and has been off therapy for at least 6 months In the opinion of the Investigator, is ready to initiate treatment (treatment naïve) or reinitiate treatment (previously treated) within the next 3 months, and for whom a delay, in order to participate in a placebo-controlled clinical trial, is considered reasonable and clinically acceptable Had clinical signs and symptoms within the 6 weeks before the date of consent that are consistent with NTM-PD with at least two of the following: 1. chronic cough 2. fatigue 3. frequent throat clearing 4. shortness of breath (dyspnea) 5. coughing up of blood (hemoptysis) 6. excessive mucus (sputum) production 7. fever 8. night sweats 9. loss of appetite 10. unintended weight loss 11. wheezing 12. chest pain Has a measured forced expiratory volume in 1 second (% predicted FEV1) ≥30% on pulmonary function test within 3 months prior to consent Has a chest radiograph (CXR) or computed tomography (CT) scan within 6 months prior to consent with findings consistent with NTM-PD. If no CXR or CT scan is available, a CXR or CT scan should be performed at screening to confirm eligibility Other per protocol  Has disseminated or extrapulmonary NTM Has end-stage NTM-PD or treatment-refractory NTM-PD and is unlikely to respond to protocol-specified SOC treatment Had isolation on sputum cultures of any species of Mycobacterium other than a species included in MAC within the past 6 months Had prior isolation of MAC with macrolide resistance Has received any systemic (oral or IV) or inhaled antibiotic with activity against MAC between consent and randomization Has a potentially confounding underlying pulmonary disease, including but not limited to cystic fibrosis, active pulmonary malignancy (primary or metastatic), NTM-hypersensitivity disease pneumoconiosis, or another advanced lung disease with a % predicted FEV1<30% Other per protocol