Place water and lager beer into a 4 1/2 quart or larger saucepan over high heat and bring to boil, add pasta and cook until just al dente. Drain and keep warm.
Meanwhile in 3 quart saucepan, over medium-high heat, bring the milk, half-and-half, and evaporated milk just to a boil, keep hot. In a 4 quart saucepan, over medium heat, melt 3 tablespoons of the butter and stir in flour until it begins to color slightly, whisk in hot milk, mustard, salt, cayenne, and stout, and bring to a strong simmer. Reduce heat to low and stir in cheeses until melted. Place pasta into serving dish and pour the cheese sauce over the pasta.
Place remaining butter in a large saute pan over medium heat and stir in bread crumbs, stir until golden brown, stir in bacon crumbles. Spread mixture over top of macaroni. Garnish with cilantro or sage leaves.
Recipe courtesy of Autumn Clements, Amelia Island, FL