Nontuberculous%20mycobacterial%20disease Management

Management

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)

Timely treatment of patients at risk for severe COVID-19 prevents severe outcomes

Dr. Asok Kurup, Dr. Alex Soriano, 31 Oct 2022

Despite widespread uptake of vaccinations, COVID-19 remains a serious health issue for high-risk patients, owing to the emergence of new variants of concern (VOCs), waning immunity, and breakthrough infections.

At a recent symposium in Singapore, esteemed experts Dr Asok Kurup, Consultant Infectious Diseases Physician at Mount Elizabeth Medical Centre, Singapore, and Dr Alex Soriano, Head of Infectious Diseases Department, Hospital Clínic of Barcelona and Assistant Professor, University of Barcelona, Spain, gave insights on the evolution of global trends since the start of the COVID-19 pandemic and discussed key challenges in managing high-risk patients with COVID-19 in the ICU. They also highlighted early treatment strategies to minimize the burden of COVID-19 on healthcare systems.

ID NOW rapid molecular assay an effective COVID-19 test for kids

Rapid COVID-19 testing: Is it as good in kids?

Roshini Claire Anthony, 20 Oct 2021

A large retrospective study from the US, presented at IDWeek 2021, has shown that the Abbott ID NOW rapid molecular COVID-19 assay is highly sensitive and specific at detecting SARS-CoV-2 infection in a paediatric population.

Optimizing hypertension management in clinical practice with nebivolol

Prof. Giuseppe Mancia, Prof. Jong-Won Ha, Prof. Lin Jiunn-Lee, 11 Jul 2018

Hypertension guidelines diﬀer in their recommendation to use beta-blockers as ﬁrst-line agents. At a Menarini-sponsored symposium held during the Asian Paciﬁc Society of Cardiology Congress 2018 in Taipei, Taiwan, Professor Giuseppe Mancia from the University of Milano-Bicocca in Milan, Italy and Professor Jong-Won Ha from the Yonsei University College of Medicine in Seoul, Korea discussed the rationale behind these recommendations, and reviewed the role of beta-blockers in hypertension management, particularly the role of vasodilatory beta-blocker nebivolol (Nebilet^®, Menarini). Professor Lin Jiunn-Lee, APSC 2018 chairman and president of the Taiwan Society of Cardiology, chaired the symposium.