Active Ingredient: Azithromycin
Many of these bacteria have been associated with a decline in lung function in CF 3 — 6. However, other microorganisms have been isolated from CF lung fluids including nontuberculous mycobacteria NTM, anaerobic bacteria, and fungi.
Although the isolation of some of these microorganisms is temporally associated with deterioration in baseline health in some individuals, it is not clear whether they are relevant pathogens in all patients.
Clinicians must discern how to proceed if one of these organisms is isolated in the absence of clinical manifestations, changes in lung function, or radiographic changes.Correspondence and requests for reprints should be addressed to James F.
In addition, the clinician must also balance the potential for development of toxicities from prescribed therapies with the possibility of beneficial effect. Further complicating the decision on whether treatment should be initiated is the need to determine the best therapeutic regimen for the individual patient.
From this symposium, two companion manuscripts were written to summarize the current evidence presented at that meeting. In Part I, the lung microbiome, methicillin-resistant S.
Practical treatment approaches are discussed in both articles. These approaches summarize the current evidence. However, it is imperative to recognize that these treatment approaches are evolving as the results of ongoing and future research studies become available.
The reader should realize that these documents are not portrayed as guideline documents or consensus recommendations. The discussions contained within these articles are not meant to represent the finish line for treating lung infections in CF but rather should be taken to represent the starting line.
Nontuberculous Mycobacteria NTM lung infections are increasingly observed in the general population and in patients with CF 8. Accelerated loss of lung function has been observed in patients with M.
As a result, many transplant centers now consider the presence of NTM lung disease a relative contraindication for transplantation 13.
Peat moss exposure in some studies has been identified as a potential exposure risk for NTM lung disease 14, 17, 18.
However, case—control studies have not clearly demonstrated an association between exposure to residential water sources or other activities including gardening and NTM lung disease 19.
It is not clear, however, whether these risk modifications impact the development of NTM lung disease.
Reports of the transmissibility of M. Although both reports describe the transmissibility of M. Therefore, close collaboration with the infection control team and abiding by infection control procedures in CF and bronchiectasis clinics, including respiratory isolation for patients with M.
The diagnosis of NTM lung disease is based on criteria outlined by the ATS, including a combination of clinical, radiographic, and microbiologic elements 9.
It is worth noting that in most circumstances and for most NTM respiratory isolates especially MAC, one positive culture, especially with low numbers of organisms, smear negative, or growth on liquid media only, is not adequate to establish a diagnosis of NTM lung disease.
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