Non-tuberculous mycobacterial (NTM) infections

Treatment of NTM infections is complex and depends of a variety of factors such as the specific organism, site and severity of infection. However, a couple of general principles would apply universally for NTM infections. Firstly, treatment requires a combination of 2 or more different antibiotic agents. Secondly, the treatment course is expected to be prolonged, generally in terms of weeks and months. If there are surgical options available, this should be exercised to optimise cure. 

With regards to NTM lung infections, the current practice in our institution would be to give a combination of 3-4 antibiotics including intravenous antibiotics in the first 4-6 weeks of treatment. This would be followed by a combination of 2-3 oral antibiotics for 6-12 months. Improvement of symptoms is expected during the course of treatment in most cases but relapses and incomplete resolution are the norm. Treatment progress will be closely monitored by the physician with regular follow ups to ensure treatment response as well as early detection and prevention of side effects of prolonged antibiotic treatment.