Treatments and Medications for Non-Tuberculous Mycobacteria (NTM)
How is NTM infection diagnosed?
An NTM infection can be more difficult to diagnose than TB. It is important for your healthcare provider to determine if the infection is TB or NTM. If it is NTM, which specific type of NTM is important. In addition, it is important for the healthcare provider to determine whether the NTM infection requires treatment. Some people harbor the germs and remain well. They may need to be observed without treatment. Others have or may be developing serious and progressive illness. A diagnosis is often based on the following:
- Medical history including your symptoms
- Chest CT scan and/or X-ray
- Sputum culture – Several sputum cultures are often necessary and must be done at specialized labs. One positive test does not always mean disease is present.
- Other procedures such as bronchoscopy may be required in certain cases.
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What is the treatment of NTM?
Most of the NTM infections are naturally resistant to many common antibiotics. It is often necessary to use some of the same medications that are used to treat TB. In order to overcome drug resistance, you may need to take several different antibiotics at the same time. Because many of these medications have side effects, close monitoring is important. Furthermore, treatment may be necessary for as long as two years. Sometimes treatment is ongoing, depending on the severity of the disease.
The most common organisms involved in human infection are M. kansasii, M. avium-complex, M. chelonae and M. abscessus. M. kansasii is easier to treat and often can be killed with only three anti-TB medications. On the other hand, organisms such as M. avium, M. chelonae and M. abscessus are among the most stubborn germs. They are more difficult to treat. Three to five medications may be needed. Depending on how localized the disease is, surgery also may be helpful.
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This information has been approved by Gwen Huitt M.D., (April 2006).
