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When and how to treat pulmonary non-tuberculous mycobacterial diseases

Thomson, Rachel & Yew, Wing-Wai (2009) When and how to treat pulmonary non-tuberculous mycobacterial diseases. Respirology, 14(1), pp. 12-26.

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Abstract

Nontuberculous mycobacteria are ubiquitous environmental organisms that have been recognised as a cause of pulmonary infection for over 50 years. Traditionally patients have had underlying risk factors for development of disease; however the proportion of apparently immunocompetent patients involved appears to be rising. Not all patients culture-positive for mycobacteria will have progressive disease, making the diagnosis difficult, though criteria to aid in this process are available. The two main forms of disease are cavitary disease (usually involving the upper lobes) and fibronodular bronchiectasis (predominantly middle and lingular lobes). For patients with disease, combination antibiotic therapy for 12-24 months is generally required for successful treatment, and this may be accompanied by drug intolerances and side effects. Published success rates range from 30-82%. As the progression of disease is variable, for some patients, attention to pulmonary hygiene and underlying diseases without immediate antimycobacterial therapy may be more appropriate. Surgery can be a useful adjunct, though is associated with risks. Randomised controlled trials in well described patients would provide stronger evidence-based data to guide therapy of NTM lung diseases, and thus are much needed.

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29 citations in Web of Science®

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ID Code: 30017
Item Type: Journal Article
Additional URLs:
Keywords: mycobacteria, nontuberculous, anti-mycobacterial therapeutics, bronchiectasis, Mycobacterium avium
DOI: 10.1111/j.1440-1843.2008.01408.x
ISSN: 1323-7799
Subjects: Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > CLINICAL SCIENCES (110300) > Infectious Diseases (110309)
Australian and New Zealand Standard Research Classification > MEDICAL AND HEALTH SCIENCES (110000) > MEDICAL MICROBIOLOGY (110800) > Medical Microbiology not elsewhere classified (110899)
Divisions: Past > QUT Faculties & Divisions > Faculty of Science and Technology
Past > Institutes > Institute for Creative Industries and Innovation
Past > Schools > School of Life Sciences
Copyright Owner: Copyright 2009 Wiley-Blackwell
Deposited On: 28 Jan 2010 21:38
Last Modified: 10 Aug 2011 18:31

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