Treatment of Disseminated Mycobacterium kansasii Infection in HIV-Negative Patients
Clinical Scenario
This protocol addresses disseminated Mycobacterium kansasii infection in individuals who are HIV-negative. Both the American Thoracic Society (ATS)/IDSA and the British Thoracic Society provide specific treatment guidance for this population, which differs from immunocompromised settings.
Treatment Approach
Management requires a structured combination of anti-tuberculosis agents, with two recognised guideline-based regimen options available. Treatment is continued until the primary clinical endpoint is reached — full regimen details, alternatives, and duration criteria are in the complete protocol.
Clinical Goal
Sputum culture conversion to negative (culture negativity).
References
DOI: 10.3389/fmicb.2018.02271
- The American Thoracic Society (ATS) and the Infectious Diseases Society of America (IDSA) recommend a combination of three anti-tuberculosis drugs, isoniazid (INH) at 300 mg/day, rifampin (RIF) at 600 mg/day, and ethambutol (EMB) at 15 mg/kg/day for treatment of M. kansasii pulmonary disease in HIV negative individuals.
- Treatment should be continued for 1 year after culture negativity.
- The British Thoracic Society recommends the inclusion of a macrolide, such as azithromycin (AZI) at 250 mg/day or 500 mg of clarithromycin (CLA) twice a day as an alternative to INH.
- Rifampin, INH, and EMB (ATS/IDSA) or RIF, CLA (or AZI), EMB (British Thoracic Society) are suggested regimens for treatment of M. kansasii infection in humans taking between 12-18 months depending on the sputum culture time of conversion.
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