Surgical Approach to Pulmonary Nontuberculous Mycobacterial Infections

Mitchell, John D.

doi:10.1016/j.ccm.2014.11.004

Cited by 28 publications

(27 citation statements)

References 10 publications

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“…In contrast, the combination of surgical resection and parenteral aminoglycoside was associated with favorable treatment outcomes in the treatment of macrolide-resistant MAC-LD (14), although surgical treatment may be associated with high complication rates (41,42). In the present study, two patients with the fibrocavitary form who underwent surgical resection combined with injectable medication achieved sputum-negative conversion.…”

Section: Discussionmentioning

confidence: 51%

Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease

Moon

Park

Kim

et al. 2016

Antimicrob Agents Chemother

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Section: Discussionmentioning

confidence: 51%

Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease

Moon

Park

Kim

et al. 2016

Antimicrob Agents Chemother

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“…Surgical resection can play an important adjunctive role in the management of NTM-LD (29, 110). However, there is a paucity of robust evidence to guide the calculation of risks and benefits of selecting NTM-LD patients for lung resection.…”

Section: Role Of Resectional Lung Surgerymentioning

confidence: 99%

“…Expert opinion emphasizes consideration of surgical resection under the following circumstances: (i) for pathogens that are less amenable to medical therapy such as M. abscessus or macrolide-resistant MAC organisms, (ii) for severely involved but localized disease ( e.g ., focal bronchiectasis or cavitation), and/or (iii) for patients who have responded poorly to initial medical treatment and for life-threatening complications such as hemoptysis (29, 110). Patients are typically treated with intensive antibiotic regimens for 2–3 months prior to surgery to maximally reduce bacterial burden (110).…”

Section: Role Of Resectional Lung Surgerymentioning

confidence: 99%

“…Patients are typically treated with intensive antibiotic regimens for 2–3 months prior to surgery to maximally reduce bacterial burden (110). ATS/IDSA guidelines conclude that – in light of the lack of widely-accepted criteria for patient selection and the high potential morbidity – decision-making regarding surgical resection should optimally be made in conjunction with experienced NTM treatment centers (29).…”

Section: Role Of Resectional Lung Surgerymentioning

confidence: 99%

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Treatment of Non-Tuberculous Mycobacterial Lung Disease

Philley

DeGroote

Honda

et al. 2016

Curr Treat Options Infect Dis

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Opinion Statement Treatment of non-tuberculous mycobacterial lung disease (NTM-LD) is challenging for several reasons including the relative resistance of NTM to currently available drugs and the difficulty in tolerating prolonged treatment with multiple drugs. Yet-to-be-done, large, multicenter, prospective randomized studies to establish the best regimens will also be arduous because multiple NTM species are known to cause human lung disease, differences in virulence and response to treatment between different species and strains within a species will make randomization more difficult, the need to distinguish relapse from a new infection, and the difficulty in adhering to the prescribed treatment due to intolerance, toxicity, and/or drug-drug interactions, often necessitating modification of therapeutic regimens. Furthermore, the out-of-state resident status of many patients seen at the relatively few centers that care for large number of NTM-LD patients pose logistical issues in monitoring response to treatment. Thus, current treatment regimens for NTM-LD is largely based on small case series, retrospective analyses, and guidelines based on expert opinions. It has been nearly 10 years since the publication of a consensus guideline for the treatment of NTM-LD. This review is a summary of the available evidence on the treatment of the major NTM-LD until more definitive studies and guidelines become available.

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“…Mitchell et al proposed 3 indications for surgery: failure of medical therapy, symptom relief, and to slow progression of disease [71]. …”

Section: Introductionmentioning

confidence: 99%

The challenge of pulmonary nontuberculous mycobacterial infection

2015

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The incidence of nontuberculous mycobacterial (NTM) lung disease is increasing. Current treatment strategies are largely based on expert opinion. The lack of randomized clinical trials to inform treatment leave clinicians with many questions regarding the most effective and safe regimens. The risk-benefit ratio of therapy is often thought to favor observation given the chronic nature of the disease, multiple long-term antibiotics recommended for therapy, side effects associated with treatment, and perceived lack of efficacious therapies.

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Surgical Approach to Pulmonary Nontuberculous Mycobacterial Infections

Cited by 28 publications

References 10 publications

Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease

Clinical Characteristics, Treatment Outcomes, and Resistance Mutations Associated with Macrolide-Resistant Mycobacterium avium Complex Lung Disease

Treatment of Non-Tuberculous Mycobacterial Lung Disease

The challenge of pulmonary nontuberculous mycobacterial infection

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