Abstract
Nontuberculous mycobacteria (NTM) are numerous, and for the vast majority of them,
randomized studies are lacking and data regarding optimal treatment are limited. When
Mycobacterium avium complex (MAC) and M. abscessus are excluded, the main NTM are M. xenopi, M. kansasii, M. malmoense, M. szulgai, and M. simiae. Treatment is long (at least 12 months after culture conversion according to recommendations
by scientific societies) and difficult (at least three drugs are required, each of
which have potential adverse events). Moreover, optimal treatment is unknown for the
vast majority of NTM and efficacy of treatment is not 100%. That is why, balance between
benefit and risk is fundamental. For M. xenopi, the second most common NTM isolated in Europe, treatment is classically based on
macrolides or fluoroquinolones, associated with ethambutol and rifampicin. For M. kansasii, the cornerstone of treatment is rifampicin, which should be associated with two
other drugs: ethambutol plus isoniazid or clarithromycin. M. malmoense, which is common in Northern Europe, can be treated by rifampicin, ethambutol, and
clarithromycin and/or fluoroquinolones.
Keywords
M. xenopi
-
M. kansasii
-
M. malmoense
- drug toxicity - macrolides - antibiotic susceptibility
