How are nontuberculous mycobacteria (NTM) infections managed or treated?
Treatment for NTM infection depends on the location of the infection and the species (type) of mycobacteria involved. Because these infections can develop slowly, your doctor may not begin treatment right away.
To treat NTM infection, your doctor will give you drugs called antibiotics such as azithromycin, ethambutol and rifampin. Doctors often prescribe a combination of three types of antibiotics to treat the mycobacteria. You may need to take these drugs for 12 months or more to make sure the infection is completely gone.
In the U.S., the first and only FDA-approved medication to specifically treat MAC lung disease as part of the antibiotic combination therapy is amikacin liposome inhalation suspension (ARIKAYCE®). A few potential side effects include voice issues, hypersensitivity pneumonitis, and bronchospasm.
For skin infections or some other types of localized NTM infection, your healthcare provider might remove damaged tissue surgically, in addition to antibiotic therapy.
What are the complications of nontuberculous mycobacteria (NTM) infections or their treatment?
The drugs used to treat NTM infections can have unpleasant side effects including nausea and vomiting. Tell your healthcare provider if you experience these side effects. Your provider can help ease the effects by changing the amount or type of medication you take.
If the bronchial tubes are damaged by an NTM infection, you may end up with the condition called bronchiectasis. The widening of the tubes leads to increased mucus which can breed bacteria and lead to increased risk of infections.
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Now, let's delve into the comprehensive understanding of the concepts mentioned in the provided article about the management and complications of NTM infections:
Management of NTM Infections:
1. Treatment Approach:
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Dependence on Location and Species: The treatment for NTM infections is contingent upon factors such as the location of the infection and the specific species or type of mycobacteria involved. Different species may exhibit variations in susceptibility to antibiotics.
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Delayed Treatment Initiation: Due to the gradual development of NTM infections, immediate treatment initiation may not be the norm. Physicians often adopt a watchful waiting approach before commencing treatment.
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Antibiotic Therapy: Key drugs used in the treatment of NTM infections include antibiotics such as azithromycin, ethambutol, and rifampin. Combination therapy with three types of antibiotics is common, and the duration of treatment may extend to 12 months or longer to ensure complete eradication of the infection.
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FDA-Approved Medication: In the United States, amikacin liposome inhalation suspension (ARIKAYCE®) is the first and only FDA-approved medication specifically designed to treat MAC lung disease as part of an antibiotic combination therapy.
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Potential Side Effects: Patients undergoing treatment, especially with ARIKAYCE®, may experience side effects like voice issues, hypersensitivity pneumonitis, and bronchospasm.
2. Localized NTM Infections:
- Skin Infections and Surgical Intervention: In cases of skin infections or certain localized NTM infections, surgical removal of damaged tissue may complement antibiotic therapy. This approach aims to enhance the efficacy of treatment.
Complications of NTM Infections and Their Treatment:
1. Drug-Induced Side Effects:
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Nausea and Vomiting: The drugs used to treat NTM infections can elicit unpleasant side effects, including nausea and vomiting. It is crucial for patients to communicate any such experiences to their healthcare providers promptly.
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Adjustment of Medication: Healthcare providers can mitigate side effects by adjusting the dosage or changing the type of medication, emphasizing the importance of open communication between patients and providers.
2. Bronchiectasis:
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Bronchial Tube Damage: In some cases, NTM infections can lead to damage of the bronchial tubes, resulting in a condition called bronchiectasis.
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Increased Mucus Production: Bronchiectasis causes the widening of bronchial tubes, leading to heightened mucus production. This environment becomes conducive to bacterial growth, elevating the risk of recurrent infections.
In summary, the management of NTM infections involves a tailored approach considering factors like infection location and mycobacterial species. Treatment spans the use of antibiotics, including FDA-approved medications, and, in specific cases, surgical intervention. Complications encompass drug-induced side effects, emphasizing the need for vigilant monitoring and open communication between patients and healthcare providers. Additionally, the potential development of bronchiectasis underscores the importance of addressing NTM infections promptly to prevent long-term complications.
