Medication for Nontuberculous Mycobacterial Infections

A doctor often prescribes a combination of antibiotics, depending on the type of mycobacteria causing your infection. Testing the organism through a sputum sample can tell a doctor which antibiotics may work best. Doctors typically recommend a combination of three to four antibiotics, such as clarithromycin, azithromycin, rifampin, rifabutin, ethambutol, streptomycin, and amikacin. They use several antibiotics to prevent the mycobacteria from becoming resistant to any one medication. 

These medications are taken daily or three times a week in pill form, inhaled form, or sometimes through a vein with intravenous (IV) infusion. IV medications are typically prescribed for people with lung infections that are resistant to initial treatment with oral or inhaled antibiotics.

Most people on IV antibiotics take them at home with the help of a home healthcare nurse, who can help administer the medication or show you or a family member how to do it. People typically use IV antibiotics daily for two or three months, then switch to antibiotics taken by mouth. 

Treatment with antibiotics lasts a year or two. Doctors prescribe medication until no mycobacteria are found in a sputum culture for a minimum of one year. Sputum is often tested every few months during follow-up visits with your doctor. For skin and soft tissue infections, treatment is typically given for at least two to three months after any skin symptoms have resolved.

Long-term use of antibiotics can cause side effects, such as nausea, diarrhea, vision changes or eye pain, and liver problems, so doctors carefully monitor people being treated for nontuberculous mycobacteria infections to prevent or manage these complications.