TY - JOUR
T1 - Non-tuberculous mycobacterial pulmonary infections
AU - Chalmers, J. D.
AU - Aksamit, T.
AU - Carvalho, A. C.C.
AU - Rendon, A.
AU - Franco, I.
N1 - Funding Information:
JD Chalmers reports research grants from Grifols, Insmed, Bayer Healthcare and Aradigm Corporation towards EMBARC, the European Bronchiectasis and NTM Registries.
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Non-tuberculous mycobacterial (NTM) infections are increasingly rapidly worldwide. The reason for this phenomenon is unclear, but may include the ageing population, the increasing use of immunosuppressive drugs, the increasing prevalence of diseases that confer susceptibility to NTM, such as COPD and bronchiectasis, and growing testing for NTM. Awareness of the NTM related diseases is rising but is still suboptimal. Guidelines from the American Thoracic Society and Infectious Diseases Society of America have provided a framework for evaluating disease and evaluating care. Compliance with these guidelines is, however, very poor globally. NTM infections are amongst the most challenging cases that respiratory and infectious diseases physicians face. The challenges include intrinsic antibiotic resistance, complex drug regimens, poor tolerability and significant side effects associated with therapy and poor response rates. The decision to initiate treatment is therefore often difficult and requires careful evaluation of benefits and risks. Optimal management of NTM infections requires multidisciplinary care with close collaboration between physicians, microbiologists, physiotherapist/allied health professionals, primary care physicians and the patient. There remains a need for greater research into the epidemiology, clinical evaluation and treatment of NTM pulmonary disease. Randomised clinical trials are now being conducted which may provide useful data on the effectiveness of some new and existing therapies. In this review, we discuss the growing importance of NTM pulmonary disease and the opportunities for progress in clinical research for these conditions.
AB - Non-tuberculous mycobacterial (NTM) infections are increasingly rapidly worldwide. The reason for this phenomenon is unclear, but may include the ageing population, the increasing use of immunosuppressive drugs, the increasing prevalence of diseases that confer susceptibility to NTM, such as COPD and bronchiectasis, and growing testing for NTM. Awareness of the NTM related diseases is rising but is still suboptimal. Guidelines from the American Thoracic Society and Infectious Diseases Society of America have provided a framework for evaluating disease and evaluating care. Compliance with these guidelines is, however, very poor globally. NTM infections are amongst the most challenging cases that respiratory and infectious diseases physicians face. The challenges include intrinsic antibiotic resistance, complex drug regimens, poor tolerability and significant side effects associated with therapy and poor response rates. The decision to initiate treatment is therefore often difficult and requires careful evaluation of benefits and risks. Optimal management of NTM infections requires multidisciplinary care with close collaboration between physicians, microbiologists, physiotherapist/allied health professionals, primary care physicians and the patient. There remains a need for greater research into the epidemiology, clinical evaluation and treatment of NTM pulmonary disease. Randomised clinical trials are now being conducted which may provide useful data on the effectiveness of some new and existing therapies. In this review, we discuss the growing importance of NTM pulmonary disease and the opportunities for progress in clinical research for these conditions.
KW - Antibiotics
KW - Bronchiectasis
KW - COPD research
KW - NTM guidelines
UR - http://www.scopus.com/inward/record.url?scp=85049959998&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85049959998&partnerID=8YFLogxK
U2 - 10.1016/j.pulmoe.2017.12.005
DO - 10.1016/j.pulmoe.2017.12.005
M3 - Short survey
AN - SCOPUS:85049959998
VL - 24
SP - 120
EP - 131
JO - Pulmonology
JF - Pulmonology
SN - 2531-0429
IS - 2
ER -