|
| | Combination | Duration | Comments |
|
| Pulmonary |
Cavitary disease
Pneumonia | Clarithromycin 500–1000 mg/d or
Azithromycin 250–300 mg/d
Rifampicin 450–600 mg/d | Up to 12 months, negative culture
Initial administration of injectable agents for 8 to 12 weeks
Streptomycin (10–15 mg/kg/3x/week)
Amikacin 8–25 mg/kg 2-3 times weekly | In case of macrolide resistance or intolerance clofazimine and quinolones may be useful based on strain resistance profiles |
Bronchiectatic-fibronodular
CF, COPD | Clarithromycin 1000 mg/d or
Azithromycin 500–600 mg/d
Ethambutol 25 mg/kg
Rifampicin 600 mg | Intermittent three times weekly
In nonresponsive output change to daily dosage | Adjuvant therapy of underlying disease, bronchodilators, airways clearance support, smoking cessation, and nutrition |
| Hypersensitivity | Prednisone 1-2 mg/kg/daily | 4–8 weeks, repeated exposure must be avoided | Long postexposure observation to exclude lung disease progression |
|
| Extrapulmonary |
| Systemic, disseminated, and HIV infection | Clarithromycin 500 mg/twice daily or
Azithromycin 1200 mg/daily
Rifabutin 300 mg/d
Ethambutol 15 mg/kg daily | Up to 12 months
Initial administration of injectable agents for 8 to 12 weeks
Streptomycin (10–15 mg/kg/3x/week)
Amikacin 8–25 mg/kg 2-3 times weekly | Prevention
Azithromycin 500 mg/daily
Ethambutol 15 mg/kg daily
or
Clarithromycin 500 mg/twice daily +/−
Rifabutin 300 mg/daily, HIV with < 50 CD4 cells/L |
| Skin, soft tissue, and osteoarticular disease | Chirurgical debridement, excision
Support:
Clarithromycin 500–1000 mg/d or
Azithromycin 250–300 mg/d
Rifampicin 450–600 mg/d | In case of indolent persistence, supportive in more excessive involvement:
Streptomycin (10–15 mg/kg/3x/week)
Amikacin 8–25 mg/kg 2-3 times weekly | |
| Lymphadenitis | Complete extirpation
Support:
Clarithromycin
Rifampicin | Duration and dosage not established,see pulmonary, consider Ethambutol with caution in infants! | Antibiotic treatment only in cases where extirpation is contraindicated or with poor outcome after surgery, considering superinfection with other microorganisms |
|
