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Multidisciplinary Viewpoints on NTM-LD Diagnosis and Management

This educational activity is sponsored by the Academy for Continued Healthcare Learning (ACHL). This educational activity is supported by an educational grant from Insmed Incorporated.

Release Date

February 28, 2022

Expiration Date

February 28, 2023


Christina O’Connor, PharmD, BCPS, AAHIV-P
Antimicrobial Stewardship Clinical Pharmacist Manager
Assistant Professor of Pharmacy, Mayo Clinic College of Medicine and Science
Rochester, MN

Stephen Ruoss, MD
Professor of Medicine, Pulmonary, Allergy and Critical Care Medicine
Stanford University School of Medicine
Stanford, CA

Jason Stout, MD, MHS
Professor of Medicine, Division of Infectious Diseases, Department of Medicine
Duke University
Chapel Hill, NC


In two virtual roundtables, a pulmonologist, infectious disease specialist, and clinical pharmacist share their experiences in addressing challenges in diagnosing and treating patients with NTM-LD. The expert panel discusses strategies for expediting diagnosis and improving patient care and outcomes within the context of a patient’s reflections on the path to diagnosis and their treatment experience. Through this approach, learners hear from a real-world patient as the multidisciplinary panel examines the timeline to diagnosis and approach to optimal management.


This activity is intended for infectious disease specialists, pulmonologists, hospitalists, internists, physicians, health-system pharmacists, and other clinicians who care for patients at risk for NTM-LD.


Upon completion of this activity, participants will be able to:

  • Identify risk factors that place certain individuals at higher risk for developing NTM-LD
  • Describe new guideline recommendations for diagnosis and treatment of NTM-LD
  • Apply clinical trial efficacy and safety data with new and emerging approaches to NTM-LD to recommendations for appropriate treatment protocols
  • Apply knowledge of treatment protocols for NTM-LD to different patient scenarios


This activity will take approximately 90 minutes to complete. To receive credit, participants are required to complete the pretest, view the online activity and complete the posttest and evaluation. To receive credit, 60% must be achieved on the posttest. A certificate will be immediately available. There is no fee to participate in the activity or for the generation of the certificate.

CPE credit will be submitted to CPE Monitor® on the first day of each month.


The Academy for Continued Healthcare Learning (ACHL) requires that the faculty participating in an accredited continuing education activity disclose all affiliations or other financial relationships (1) with the manufacturers of any commercial product(s) and/or provider(s) of commercial services discussed in an educational presentation and (2) with any commercial supporters of the activity. All conflicts of interest have been mitigated prior to this activity.

The following financial relationships have been provided:

Christina O’Connor, PharmD, BCPS, AAHIV-P
No financial relationships to disclose

Stephen Ruoss, MD
Consultant (occasional): N2 Therapeutics; Paratek Pharmaceuticals

Jason Stout, MD, MHS
No financial relationships to disclose

Discussion of Off-Label, Investigational, or Experimental Drug/Device Use

Azithromycin, rifampicin, ethambutol, amikacin (intravenous), streptomycin, isoniazid, imipenem, cefoxitin, tigecycline, clofazimine, linezolid, and moxifloxacin are not indicated for the treatment of nontuberculous mycobacterial lung disease; rifabutin and clarithromycin are not indicated for the treatment of nontuberculous mycobacterial lung disease other than that caused by Mycobacterium avium complex (MAC); amikacin liposome inhalation suspension is not indicated for the treatment of nontuberculous mycobacterial lung disease other than refractory MAC.


acpeThe Academy for Continued Healthcare Learning is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This activity has been approved for 1.50 contact hours.

ACPE Universal Activity Number: 0396-0000-22-003-H01-P
Activity Type(s): Application


Module 1: Pathway to diagnosis

  1. Recognition of NTM-LD
    • Rising rates and diagnostic delays in NTM-LD
    • Recognizing risk factors to improve early detection of NTM-LD
    • Diagnostic criteria for NTM-LD

Module 2: Treatment

  1. Considerations for treatment
  2. Applying guideline recommendations and current evidence to specific patient scenarios
    • Newly diagnosed macrolide-susceptible MAC pulmonary disease
    • Newly diagnosed macrolide-resistant MAC pulmonary disease
    • MAC pulmonary disease after failure of guideline-based treatment
    • Rifampicin-susceptible M. kansasii pulmonary disease
    • M. abscessus pulmonary disease


The rates of NTM-LD are increasing and, as a result, clinicians must be increasingly aware of the risk factors, testing protocols, and appropriate treatments to meet the needs of this growing population of patients. In addition, patient management is complicated by the limited armamentarium of antimicrobials available to treat this infection, requiring clinicians to be especially careful in treatment selection. However, there is currently a wide gap between ideal and current clinical practice in NTM-LD, and there is significant need for education providing clinicians with information on the latest guidelines; moreover, when considering the morbidity and mortality associated with NTM-LD and the current delays in diagnosis, it is also imperative to raise awareness of the disease and its risk factors. Only when clinicians are well-informed and confident in their ability to treat patients with NTM-LD will patients receive the highest quality care and the best chance for a positive outcome.


The content for this activity was developed independently of the commercial supporter. All materials are included with permission. The opinions expressed are those of the faculty and are not to be construed as those of the publisher or grantor.

This educational activity was planned and produced in accordance with the ACCME Standards for Integrity and Independence in Accredited Continuing Education, as well as the ACPE Accreditation Standards for Continuing Pharmacy Education. Recommendations involving clinical medicine in a continuing medical education (CME/CE) activity must be based on evidence that is accepted within the profession of medicine as adequate justification for their indications and contraindications in the care of patients. All scientific research referred to, reported, or used in CME/CE in support or justification of a patient care recommendation must conform to the generally accepted standards of experimental design, data collection, and analysis.

This CME/CE activity might describe the off-label, investigational, or experimental use of medications that may exceed their FDA-approved labeling. Physicians should consult the current manufacturers’ prescribing information for these products. ACHL requires the speaker to disclose that a product is not labeled for the use under discussion.

Staff and Reviewer Disclosures

ACHL staff members and others involved with the planning, development, and review of the content for this activity have no relevant affiliations or financial relationships to disclose.


Please ensure the computer system you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac &/Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Peripherals: Computer speakers or headphones
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft PowerPoint, Flash Player & HTML5