Treating an NTM Infection
How has NTM affected your practice? Answer the question below and see how other physicians around the country have answered.
What is the most common factor you consider before you begin treating for pulmonary NTM infection?
Therapy for pulmonary nontuberculous mycobacteriosis requiring treatment
Treatment options currently available
The current diagnostic criteria and treatment strategies for pulmonary infections caused by NTM can be found in the 2017 BTS Guidelines for the management of non-tuberculous mycobacterial pulmonary disease and alternatively are summarised in the statement by the American Thoracic Society (ATS)/Infectious Disease Society of America (IDSA) from 2007
Monitoring response to treatment
How do I know if the therapy is successful?
In order to assess the response to therapy the American Thoracic Society (ATS)/Infectious Diseases Society of America (IDSA) statement suggests the following: 8, 12
- Monthly checks of the sputum
- After 3 to 6 months, patients should achieve a clinical improvement
- Within 12 months patients should show no traces of pathogens in the sputum while on macrolide-containing regimens
- The recommended end point in therapy is a pathogen-free sputum for a full period of 12 months while on treatment
Aim: Culture Conversion
The ATS/IDSA statement from 2007 is the most current standard on managing and treating NTM lung infections.
The ATS statement states that the aim should be to continue therapy until sputum cultures remain negative over 12 months. Since the duration of treatment – with good clinical success – is oriented towards microbiological findings, among other things, the treatment period is usually 18 months.8