NTM: Treatment

This information was reviewed and approved by Shannon H. Kasperbauer, MD (7/1/2017).

There are different goals of therapy. Of course, the most important goal is cure.

Depending on the species, that may be possible. Cure is defined by a microbiologic outcome. If sputum cultures become negative and remain negative after treatment that is a microbiologic cure. We also follow clinical symptoms and anticipate that treatment results in resolution of fevers, night sweats, cough, etc. finally, we follow imaging (CT scans of the chest) while on treatment. We monitor for improvement in nodularity, closure of cavities and decrease in inflammation.

I was 22 years old, I was eating 7,000-8,000 calories of food a day, and I was still losing weight. I couldn't breathe, I couldn't sleep, I had night sweats, I literally went from being a top bike racer and athlete to not being able to walk up a flight of stairs.

For a year and a half, my health continued to deteriorate, but nobody could come up with a specific diagnosis that made sense.

A physician in Tucson, Arizona referred my case to Denver to National Jewish Health, and within days, they were able to identify specifically what disease I had, NTM, bacterial infection in my lungs, and how to treat it, how to move forward.

Each and every medical staff member at National Jewish collaborates on each and every case. And, it's such an amazing orchestration to see how that happens. They're in my corner, they're my team.

Without National Jewish in my life, I would not be a rock climber. I would not have summited peaks in Alaska.

Most likely by now, I wouldn't be here if it wasn't for National Jewish. They um, they keep me alive.

Most of the nontuberculous mycobacteria are naturally resistant to common antibiotics. The treatment regimens recommended vary greatly depending on the species. Some of medications used to treat NTM happen to treat tuberculosis (TB) as well. To overcome drug resistance, people with NTM may need to take several different antibiotics at the same time. Typically, the regimen includes three antibiotics. Because these medications may have side effects, close monitoring is important. Furthermore, treatment may be necessary for as long as two years. The goal of treatment is to achieve “negative” sputum cultures and maintain that for 12 months before stopping. Sometimes treatment is ongoing, depending on the severity of the disease.

The most common organisms involved in human infection are M. avium complex, M. kansasii 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 complex, 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.

Clinical Trials

For more than 100 years, National Jewish Health has been committed to finding new treatments and cures for diseases. Search our clinical trials.