Current treatment of atypical mycobacteriosis.
BACKGROUND
Atypical mycobacteria are a heterogeneous group of organisms that are of increasing importance because of the growing number of infections they cause. This rising rate of infection is due mainly to the increase in the number of susceptible (and especially immunosuppressed) patients.


OBJECTIVE
To revise the currently used treatment schemes of the most commonly isolated atypical mycobacteria.


METHODS
Literature review using reference books and PubMed with specific keywords for each mycobacteria.


CONCLUSIONS
The first important step in the management of atypical mycobacteria is to recognize the true infections caused by these organisms. The treatment required varies according to species. Well-characterized combinations exist for most common isolates, with the use of first-line antituberculous drugs (isoniazid, rifampin, ethambutol), clarithromycin, aminoglycosides and/or quinolones for slowly growing species (Mycobacterium avium complex, Mycobacterium kansasii, Mycobacterium xenopi, Mycobacterium ulcerans, Mycobacterium marinum, Mycobacterium lentiflavum, Mycobacterium malmoense) and macrolides, quinolones, amikacin and other antibiotics for rapidly growing mycobacteria (Mycobacterium abscessus, Mycobacterium chelonae, Mycobacterium fortuitum). Surgical therapy is also important for some species (Mycobacterium ulcerans, Mycobacterium scrofulaceum) and for localized infections. The treatment of uncommon species is not well defined and is determined by the results of in vitro tests of individual strains. Because of the increasing number of resistant strains, new antibiotics need to be used for the treatment of these strains.
Esteban
Jaime
J
Department of Clinical Microbiology, Fundación Jiménez Díaz, Av. Reyes Católicos 2, 28040-Madrid, Spain. jestebanmoreno@gmail.com
Ortiz-Pérez
Alberto
A
D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use*; D006801:Humans; D009164:Mycobacterium Infections / Q000188:drug therapy* / Q000382:microbiology; D009170:Nontuberculous Mycobacteria / Q000145:classification / Q000302:isolation & purification*
D000900:Anti-Bacterial Agents