Nontuberculous mycobacterial lung disease. Substantiation of a less aggressive approach

D B Hornick; C S Dayton; G N Bedell; R B Fick Jr

doi:10.1378/chest.93.3.550

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Nontuberculous mycobacterial lung disease. Substantiation of a less aggressive approach

Journal article

Peer reviewed

Nontuberculous mycobacterial lung disease. Substantiation of a less aggressive approach

D B Hornick, C S Dayton, G N Bedell and R B Fick Jr

Chest, Vol.93(3), pp.550-555

03/1988

DOI: 10.1378/chest.93.3.550

PMID: 3342664

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Abstract

A nonsurgical, less aggressive, less toxic chemotherapeutic protocol for the management of nontuberculous mycobacterial (NTB) pulmonary infections has been uniformly applied to patients in our institution between 1972 and 1985. Forty-three nonimmunocompromised patients with active lung disease caused by Mycobacterium avium-intracellulare (MAI) (n = 26), M kansasii (n = 16), and M xenopi (n = 1) were identified retrospectively. Eighteen MAI patients were treated with three or four antituberculosis agents resulting in sputum conversion and clinical improvement in 12 (67 percent). Additionally, 11 out of 16 (69 percent) patients completing therapy or still undergoing therapy for persistent MAI disease, achieved sputum conversion and clinical improvement after prolonged therapy (3.6 +/- 0.5 years [SEM]). When M kansasii was identified as the etiologic agent, all patients were treated with four or fewer antituberculosis agents and 14 out of 16 patients (88 percent) achieved sputum conversion and clinical improvement throughout the follow-up period. We conclude that the use of three or four chemotherapeutic agents in the treatment of NTM lung disease provides an excellent probability of successful outcome even in MAI infections.

Sputum - microbiology

Antitubercular Agents - adverse effects

Humans

Middle Aged

Drug Evaluation

Male

Nontuberculous Mycobacteria - isolation & purification

Mycobacterium Infections - drug therapy

Mycobacterium avium - isolation & purification

Time Factors

Mycobacterium Infections, Nontuberculous - microbiology

Aged, 80 and over

Adult

Female

Mycobacterium Infections - microbiology

Aged

Drug Therapy, Combination

Mycobacterium Infections, Nontuberculous - drug therapy

Antitubercular Agents - therapeutic use

Details

Title: Subtitle: Nontuberculous mycobacterial lung disease. Substantiation of a less aggressive approach
Creators: D B Hornick - Pharmacy Services, University of Iowa Hospitals and Clinics, Iowa City
C S Dayton
G N Bedell
R B Fick Jr
Resource Type: Journal article
Publication Details: Chest, Vol.93(3), pp.550-555
DOI: 10.1378/chest.93.3.550
PMID: 3342664
ISSN: 0012-3692
eISSN: 1931-3543
Grant note: HL 35870 / NHLBI NIH HHS HL 01065 / NHLBI NIH HHS
Language: English
Date published: 03/1988
Academic Unit: Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
Record Identifier: 9984094665102771

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29 Times Cited - Web of Science