A 48-year-old man presents with chronic productive cough, recurrent sinusitis, and bronchiectasis. Sputum culture repeatedly grows Pseudomonas

Question

A 48-year-old man presents with chronic productive cough, recurrent sinusitis, and bronchiectasis. Sputum culture repeatedly grows Pseudomonas aeruginosa. He is also found to have elevated sweat chloride at 65 mmol/L. Sputum now grows an acid-fast organism identified as Mycobacterium abscessus. What treatment principle applies to M. abscessus pulmonary disease?

Accepted Answer

Multi-drug regimen including IV Amikacin, IV Tigecycline or Imipenem, and oral macrolide

Answer

Standard 6-month anti-TB therapy (RHZE) as the preferred next management strategy

Answer

Clarithromycin monotherapy for 12 months as the preferred next management strategy

Answer

Inhaled Colistin alone for 3 months as the preferred next management strategy

Answer

IV Ceftriaxone for 6 weeks as the preferred next management strategy in this patient

Non-tuberculous Mycobacteria — SCE Infectious Diseases MCQ