Managing pulmonary nontuberculous mycobacterial infection: Time for a patient-centered approach

Giovanni Satta, Timothy Daniel McHugh, James Mountford, Ibrahim Abubakar, Marc Lipman

Research output: Contribution to journalReview articlepeer-review

31 Citations (Scopus)

Abstract

The incidence of nontuberculous mycobacteria is increasing worldwide. However, the evidence base for clinicalmanagement comprises mostly expert opinion, case series, and few randomized clinical trials. Most currently recommended treatment regimens entail prolonged use of multiple antimicrobial agents associated with multiple self-limited and persistent potential adverse effects, including irreversible impairments of hearing, vision, and kidney function. Yet, little is known about how treatment impacts an individual patient's overall health status. Current treatment guidelines, although of undoubted value, are constrained by these limitations. Here we call for new studies that reassess recommendations for medical management of pulmonary nontuberculous mycobacteria infections, in particular Mycobacterium avium-intracellulare complex and Mycobacterium abscessus complex. We propose pragmatic, person-centered outcome measures that might be used in clinical assessments and new research studies, including patient-reported experience measures and patient-reported outcome measures. This will enable patients and their health-care providers to make clinical management decisions that derive from a realistic view of what they can hope to achieve from treatment.

Original languageEnglish
Pages (from-to)117-121
Number of pages5
JournalAnnals of the American Thoracic Society
Volume11
Issue number1
DOIs
Publication statusPublished - 2014

Keywords

  • Antibacterial agents
  • Mycobacterium abscessus
  • Mycobacterium avium complex
  • Mycobacterium avium-intracellulare
  • Mycobacterium infections, atypical

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