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Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics
Nontuberculous mycobacterial (NTM) pulmonary disease (PD) is an emerging condition with heterogeneous manifestations from both the microbiological and the clinical point of view. Diagnostic and therapeutic guidelines are available but there are still unmet patients' and physicians' needs,...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
European Respiratory Society
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141831/ https://www.ncbi.nlm.nih.gov/pubmed/34046491 http://dx.doi.org/10.1183/23120541.00574-2020 |
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author | Faverio, Paola De Giacomi, Federica Bodini, Bruno Dino Stainer, Anna Fumagalli, Alessia Bini, Francesco Luppi, Fabrizio Aliberti, Stefano |
author_facet | Faverio, Paola De Giacomi, Federica Bodini, Bruno Dino Stainer, Anna Fumagalli, Alessia Bini, Francesco Luppi, Fabrizio Aliberti, Stefano |
author_sort | Faverio, Paola |
collection | PubMed |
description | Nontuberculous mycobacterial (NTM) pulmonary disease (PD) is an emerging condition with heterogeneous manifestations from both the microbiological and the clinical point of view. Diagnostic and therapeutic guidelines are available but there are still unmet patients' and physicians' needs, including therapy-related adverse events, symptom control, management of comorbidities, risk of re-exposure to the pathogen and unfavourable outcomes. In the present review, we provide currently available evidence for an integrated approach to NTM-PD beyond antibiotic therapy. This includes 1) avoiding exposure to environments where mycobacteria are present and careful evaluation of lifestyle and habits; 2) implementing a personalised pulmonary rehabilitation plan and airway clearance techniques to improve symptoms, exercise capacity, health-related quality of life (QoL) and functional capacity in daily living activities; 3) a nutritional evaluation and intervention to improve health-related QoL and to control gastrointestinal side-effects during antimicrobial therapy, particularly in those with low body mass index and history of weight loss; and 4) managing comorbidities that affect disease outcomes, including structural lung diseases, immune status evaluation and psychological support when appropriate. |
format | Online Article Text |
id | pubmed-8141831 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | European Respiratory Society |
record_format | MEDLINE/PubMed |
spelling | pubmed-81418312021-05-26 Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics Faverio, Paola De Giacomi, Federica Bodini, Bruno Dino Stainer, Anna Fumagalli, Alessia Bini, Francesco Luppi, Fabrizio Aliberti, Stefano ERJ Open Res Reviews Nontuberculous mycobacterial (NTM) pulmonary disease (PD) is an emerging condition with heterogeneous manifestations from both the microbiological and the clinical point of view. Diagnostic and therapeutic guidelines are available but there are still unmet patients' and physicians' needs, including therapy-related adverse events, symptom control, management of comorbidities, risk of re-exposure to the pathogen and unfavourable outcomes. In the present review, we provide currently available evidence for an integrated approach to NTM-PD beyond antibiotic therapy. This includes 1) avoiding exposure to environments where mycobacteria are present and careful evaluation of lifestyle and habits; 2) implementing a personalised pulmonary rehabilitation plan and airway clearance techniques to improve symptoms, exercise capacity, health-related quality of life (QoL) and functional capacity in daily living activities; 3) a nutritional evaluation and intervention to improve health-related QoL and to control gastrointestinal side-effects during antimicrobial therapy, particularly in those with low body mass index and history of weight loss; and 4) managing comorbidities that affect disease outcomes, including structural lung diseases, immune status evaluation and psychological support when appropriate. European Respiratory Society 2021-05-24 /pmc/articles/PMC8141831/ /pubmed/34046491 http://dx.doi.org/10.1183/23120541.00574-2020 Text en Copyright ©The authors 2021 https://creativecommons.org/licenses/by-nc/4.0/This version is distributed under the terms of the Creative Commons Attribution Non-Commercial Licence 4.0. For commercial reproduction rights and permissions contact permissions@ersnet.org (mailto:permissions@ersnet.org) |
spellingShingle | Reviews Faverio, Paola De Giacomi, Federica Bodini, Bruno Dino Stainer, Anna Fumagalli, Alessia Bini, Francesco Luppi, Fabrizio Aliberti, Stefano Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title | Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title_full | Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title_fullStr | Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title_full_unstemmed | Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title_short | Nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
title_sort | nontuberculous mycobacterial pulmonary disease: an integrated approach beyond antibiotics |
topic | Reviews |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8141831/ https://www.ncbi.nlm.nih.gov/pubmed/34046491 http://dx.doi.org/10.1183/23120541.00574-2020 |
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