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Over the three species combined, different therapeutic regimens (REClari and RECipro), did not differ meaningfully in terms of deaths due to mycobacteria, failures of treatment, relapses and deaths due to all causes. Immunotherapy with four doses of M. vaccae over the first 6 months did not improve the outcome. Immunotherapy with M. vaccae has not fulfi lled expectations when used in the treatment of tuberculosis. The same disappointing result has now been demonstrated in the treatment of pulmonary disease caused by opportunist myocobacteria. As these diseases appear to be markers of poor health, optimising general health, managing comorbidity in this population and research for better antimycobacterial drugs are needed urgently.

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