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Boletim de Pneumologia Sanitária

versión impresa ISSN 0103-460X

Resumen

CAMPOS, Hisbello S.. Manejo da doença micobacteriana não-tuberculosa. Bol. Pneumol. Sanit. [online]. 2000, vol.8, n.2, pp.39-50. ISSN 0103-460X.

The role of nontuberculous mycobacterias as etiologic agents of several diseases has been reconized recently and the knowledge about nontuberculous mycobacterial disease has been evoluting during the last years. Diagnostic guidelines have been developed and, although limited, they help identifying patients with indolent disease during long-term follow-up. Among the diseases caused by nontuberculous mycobacterias, it seems that those caused by Mycobacterium avium-intracellularee complex (MAC) are more frequent. The pathogenesis of nontuberculous mycobacterial (NTMB) diseases still is poorly understood, but no genetic predisposition or specific immune deficiency has been identified so far. The optimal treatment for patients with NTMB lung disease remains to be determined, but it is clear that therapeutic regimens that contains a macrolide (clarithromycin or azithromycin) are most effective. Unfortunately,drug-related side effects are still a significant and limiting problem. Although associated with frequent complications, surgery is important for selected patients. Both treatment and prophylaxis of disseminated MAC disease in HIV infected or aids patients are quite effective with macrolide-containing regimens. Patients with MAC disease respond well microbiologically to two-drugs regimens (clarithromycin and ethambutol). On the other hand, the incidence of clarithromycin side effects is higher with this two-drug regimen

Palabras clave : Nontuberculous mycobacteria; Mycobacterium avium complex.

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