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Treatment of Mycobacterium avium complex lung infection in adults

Authors
Shannon Kasperbauer, MD
Charles L Daley, MD
Section Editor
C Fordham von Reyn, MD
Deputy Editor
Allyson Bloom, MD

INTRODUCTION

Treatment of nontuberculous mycobacterial (NTM) infection of the lung is dependent upon a number of factors, including the species of the infecting organism. Members of Mycobacterium avium complex (MAC) are the most common pulmonary NTM pathogens in almost all regions of the world. The three predominate species to cause human disease within this complex are M. avium, M. intracellulare, and M. chimaera [1,2].

The treatment of MAC pulmonary infections will be reviewed here. The management of lung disease caused by other slow-growing NTM, such as Mycobacterium kansasii, Mycobacterium malmoense, and Mycobacterium xenopi, and by rapidly growing mycobacterium, such as Mycobacterium abscessus, Mycobacterium fortuitum complex, and Mycobacterium chelonae, are discussed separately. (See "Treatment of lung infection with Mycobacterium kansasii and other less common nontuberculous mycobacteria in adults" and "Rapidly growing mycobacterial infections: Mycobacteria abscessus, chelonae, and fortuitum".)

The epidemiology, microbiology, clinical manifestations, and diagnosis of NTM infection are also discussed elsewhere. (See "Overview of nontuberculous mycobacterial infections in HIV-negative patients" and "Epidemiology of nontuberculous mycobacterial infections" and "Diagnosis of nontuberculous mycobacterial infections of the lungs in HIV-negative patients".)

CATEGORIES OF DISEASE

In general, antimycobacterial treatment of MAC should only be considered in patients who meet the clinical, radiographic, and microbiologic criteria for the diagnosis of nontuberculous mycobacterial (NTM) infection (table 1) [3]. (See "Diagnosis of nontuberculous mycobacterial infections of the lungs in HIV-negative patients".)

Pulmonary NTM infection can be further categorized based on radiologic criteria, as follows:

                               
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Literature review current through: Sep 2017. | This topic last updated: Mar 16, 2017.
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