My son (4) has used pulmozyme daily for about 1 1/2 years now for preventative reasons...which means it's hard to say if it is keeping him healthy or if he'd be in fine shape without it. It does not take long to nebulize and has given him no ill side effects and we've had no trouble with insurance covering it, so we figure it's worth doing. Hypertonic saline is a popular alternative that has its own advocates, though some say it is addressing a different issue than pulmozyme. My son's doctor is not a big fan of HS so he's not tried it.