nontuberculous%20mycobacterial%20disease
NONTUBERCULOUS MYCOBACTERIAL DISEASE
Nontuberculous mycobacteria are ubiquitous and are usually found in soil, natural and treated water sources. They are relatively uncommon cause of pulmonary disease and likely to cause disseminated disease.
May cause both asymptomatic infection and symptomatic disease in humans.
There is no evidence of animal-to-human or human-to-human transmission in immunocompetent hosts.
Nontuberculous mycobacterial pulmonary disease is a generally slowly progressive infection.
Signs and symptoms are generally nonspecific.

Monitoring

Continual Monitoring

  • Patients should have frequent sputum mycobacterial culture throughout the therapy
  • The risk of adverse reactions &/or toxicities is relatively high in multidrug therapy

When monitoring for improvement, take into account the following factors:

  • Symptomatic improvement after 6 months of appropriate therapy
  • Radiographic regression of pulmonary findings after 6 months of appropriate therapy
  • Conversion of sputum smear &/or culture to negative after 12 months of appropriate therapy

Evaluate Patients for Adverse Drug Reactions

GI Disturbances

  • Associated w/ Clarithromycin, Azithromycin
    • Dose & serum level related
  • May also be seen w/ Rifabutin, Rifampicin
  • Include metallic taste, vomiting, nausea, diarrhea

Rash

  • Hypersensitivity reactions are seen w/ Rifampicin, Rifabutin

Arthralgia

  • Commonly seen w/ Rifabutin

Ocular Toxicity

  • Seen w/ Ethambutol, Rifabutin

Vestibular or Auditory Toxicity

  • Seen w/ Azithromycin, Streptomycin, Amikacin

Monitor Laboratory Measurements as Necessary

  • Monitor hematologic parameters, especially white blood cells in patients taking Rifabutin
  • Monitor visual acuity (for Ethambutol, Rifabutin), red-green discrimination (for Ethambutol)
  • Monitor LFT in patients taking the following drugs: Clarithromycin, Azithromycin, Rifabutin, Rifampicin, Isoniazid, Ethionamide
  • Monitor renal function (for Rifabutin)
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Respirology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Stephen Padilla, 3 days ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
Pearl Toh, 5 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
Jairia Dela Cruz, 3 days ago
A treatment regimen combining daratumumab plus bortezomib, melphalan and prednisone markedly extends progression-free survival in patients with multiple myeloma, inducing deep responses and demonstrating acceptable tolerability regardless of baseline renal function, according to the results of the phase III ALCYONE study.
Yesterday
Segmentectomy and lobectomy confer similar overall survival (OS) and lung cancer-specific survival (LCSS) among patients with primary nonsmall cell lung cancer (NSCLC) of ≤20 mm without lymph node or distant metastasis, a recent study has shown.