Nontuberculous Mycobacterial Lung Disease: Real-World Application of New Guidelines and Treatment Advances

Nontuberculosis mycobacterial lung disease (NTM-LD) is a frequently fatal lung disease that is now more common than tuberculosis in the United States. Treatment is generally very challenging due to lack of medications approved for first-line therapy, adverse events, drug-drug interactions, need for long-term dual and triple combination therapy, among other issues. In the first of this 2-part activity, Drs. Shannon Kasperbauer and Kevin Winthrop discuss the recommendations in the 2020 ATS/ERS/ESCMID/IDSA guidelines, for which Dr. Winthrop was a senior author, and the evidence supporting the recommendations. Extensive discussion focuses on the macrolides and aminoglycosides, including treatment advances. The second part includes case studies to illustrate how to individualize the guideline recommendations so that treatment is initiated and optimized to best meet the needs and characteristics of the individual patient. Throughout the activity, the faculty share their experiences and provide pearls and pitfalls in overcoming the challenges in managing patients with NTM-LD, such as taking medications with ice cream in the evening to improve adherence and promote weight gain. Join the highly experienced faculty as they help in the real-world application of the new guidelines and treatment advances.