The British Thoracic Society (BTS) has published new guidelines for the management of non-tuberculous mycobacterial pulmonary disease (NTM-PD).

It includes the best available evidence combined with expert consensus to generate pragmatic guidance that will assist in the management of these challenging infections.  

The full guideline is published in Thorax this month and a summary of the recommendations is also available in BMJ Open Respiratory Research.

It is aimed at healthcare practitioners who are involved in the care of individuals with NTM-PD, which will include hospital specialists in respiratory medicine, infectious diseases, paediatrics, microbiology, immunology and radiology.

According to the guidance, the incidence and prevalence of NTM-PD is increasing and is most likely explained by improved clinician awareness and enhanced detection methods, as well as a variety of changing environmental, mycobacterial and host factors. 

The following is addressed in the guidance:

  • Epidemiology—incidence, prevalence and risk factors
  • Microbiology—types of samples, detection and speciation
  • Definition of NTM-PD and indications for treatment
  • Antibiotic treatment regimens for specific NTM species
  • Role of drug susceptibility testing
  • Non-antibiotic treatment—interferon-gamma, Mycobacterium vaccae
  • Investigation of individuals suspected of having NTMPD and investigations to be undertaken during and after treatment
  • Role of thoracic surgery
  • Impact of NTM on lung transplant eligibility.