Management of nontuberculous mycobacterial Pulmonary disease refractory to guideline-based therapy: A systematic review - PubMed
4 hours ago
- #antibiotic resistance
- #NTM-PD
- #systematic review
- Managing refractory nontuberculous mycobacterial pulmonary disease (NTM-PD) is challenging due to limited treatment options and complex disease progression.
- A systematic review examined studies on NTM-PD treatment failure, focusing on factors, intensification strategies, and supportive measures.
- Severe baseline radiological findings and multiple prior regimen modifications were linked to lower treatment success.
- Supportive interventions like nutritional counseling and respiratory rehabilitation have limited evidence but may help.
- Intermittent intravenous antibiotics can aid symptom control, and additional antibiotics may intensify treatment depending on the NTM species.
- Surgical resection may be considered for localized disease, but recurrence risk remains high, especially with preoperative positive cultures.
- Novel therapeutic approaches are under investigation as potential alternatives.
- Individualized strategies incorporating clinical, microbiological, and radiological factors are essential for optimizing patient outcomes.