American Thoracic Society Quick-Reference GUIDELINES Apps
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6 Treatment Mycobacterium xenopi (Table 2) ➤ In patients with M. xenopi pulmonary disease, we suggest using a multidrug treatment regimen that includes moxifloxacin or macrolide (conditional recommendation, very low certainty in estimates of effect). ➤ In patients with M. xenopi pulmonary disease, we suggest a daily regimen that includes at least 3 drugs: rifampicin, ethambutol, and either a macrolide and/or a fluoroquinolone (eg, moxifloxacin) (conditional recommendation, very low certainty in estimates of effect). ➤ In patients with cavitary or advanced/severe bronchiectatic M. xenopi pulmonary disease, we suggest adding parenteral amikacin to the treatment regimen and obtaining expert consultation (conditional recommendation, very low certainty in estimates of effect). Mycobacterium abscessus (Table 5) ➤ In patients with M. abscessus pulmonary disease caused by strains without inducible or mutational resistance, we recommend a macrolide-containing multidrug treatment regimen (strong recommendation, very low certainty in estimates of effect). ➤ In patients with M. abscessus pulmonary disease caused by strains with inducible or mutational macrolide resistance, we suggest a macrolide-containing regimen if the drug is being used for its immunomodulatory properties although the macrolide is not counted as an active drug in the multidrug regimen (conditional recommendation, very low certainty in estimates of effect). ➤ In patients with M. abscessus pulmonary disease, we suggest a multidrug regimen that includes at least 3 active drugs (guided by in vitro susceptibility) in the initial phase of treatment (conditional recommendation, very low certainty in estimates of effect). ➤ In patients with M. abscessus pulmonary disease, we suggest that either a shorter or longer treatment regimen be used and expert consultation obtained (conditional recommendation for either the intervention or the comparison, very low certainty in estimates of effect). Surgical Resection ➤ In selected patients with NTM pulmonary disease, we suggest surgical resection as an adjuvant to medical therapy after expert consultation (conditional recommendation, very low certainty in estimates of effect).