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1. What is an appropriate initial drug treatment option for drug-sensitive pulmonary Mycobacterium avium complex disease?

A. Isoniazid + rifampin + pyrazinamide + ethambutol B. Amikacin + moxifloxacin C. Bedaquiline + clofazimine + amikacin liposome inhalation suspension D. Azithromycin + ethambutol + rifampin E. Unsure

2. What is an appropriate initial treatment choice for drug-sensitive pulmonary Mycobacterium kansasii infection?

A. Rifampin + ethambutol + isoniazid B. Amikacin + moxifloxacin + erythromycin C. Bactrim + clofazimine + amikacin liposome inhalation suspension D. Intravenous (IV) cefoxitin + IV amikacin + IV tigecycline + azithromycin E. Unsure

3. What is an appropriate initial treatment for macrolide-sensitive Mycobacterium abscessus pulmonary infection?

A. Isoniazid + rifampin + pyrazinamide + ethambutol B. Clofazimine + bedaquiline + clarithromycin C. Azithromycin + intravenous (IV) imipenem + IV amikacin + IV tigecycline D. Clofazimine + amikacin liposome inhalation suspension + doxycycline E. Unsure

4. A patient with Stage 4 chronic kidney disease received clarithromycin and ethambutol for Mycobacterium avium complex (MAC) pulmonary disease but did not convert cultures after 12 months. The most recent culture showed a MAC isolate with a minimum inhibitory concentration greater than 64 mcg/ml. What would be a reasonable treatment choice?

A. Rifabutin + moxifloxacin + amikacin liposome inhalation suspension B. Isoniazid + rifampin + pyrazinamide + ethambutol C. Bedaquiline D. Intravenous amikacin + azithromycin E. Unsure

5. Which adverse effect(s) do NOT belong to the antimycobacterial drug listed?

A. Intravenous (IV) amikacin: nephrotoxicity, hearing loss, vestibular (balance) toxicity B. Ethambutol: dose-dependent optic neuritis C. Clarithromycin: appetite loss, dyspepsia, metallic taste D. IV tigecycline: hunger, increased appetite E. Unsure

6. Which of the following is NOT one of the advantages of amikacin liposome inhalation suspension in the treatment of pulmonary nontuberculous mycobacterium (NTM) disease?

A. Direct delivery of drug to site of action B. Reduced incidence of systemic adverse effects compared to intravenous amikacin C. Titratable dosing schedule until toxicity or intolerance develops D. Randomized controlled data published to support its use in pulmonary NTM disease E. Unsure

7. Which of the following therapies for nontuberculous mycobacterial disease would require use under an institutional review board or a new drug application?

A. Bedaquiline B. Clofazimine C. Tedizolid D. Isoniazid E. Unsure

8. JO is a 58-year-old female being treated for Mycobacterium abscessus infection with oral clarithromycin, intravenous (IV) amikacin, and IV cefoxitin. Baseline serum creatinine is 0.9 mg/dL. What monitoring should be recommended for the amikacin?

A. Use adjusted body weight for dosing and the Hartford nomogram to determine the dosing interval B. Use total body weight for dosing and obtain serum peak and trough levels after steady state is reached; adjust dose to target, then monitor trough only weekly C. Use adjusted body weight for dosing and obtain 2-hour and 6-hour levels after the end of the amikacin infusion; adjust dose to target, then monitor trough only weekly D. Use total body weight for dosing and obtain 2-hour and 6-hour levels after the end of the amikacin infusion; adjust dose to target, then monitor trough only weekly E. Unsure

9. Which of the following are considered indications for therapeutic drug monitoring of oral nontuberculous mycobacterium (NTM) disease therapy?

A. Failure of NTM regimen without known cause B. History of Roux-en-Y procedure C. Patient on dialysis D. All of the above E. Unsure

10. Which of the following patient counseling points is inappropriate for the indicated drug therapy used in pulmonary NTM infections?

A. Clarithromycin – recommend taking with a meal to minimize GI upset B. Moxifloxacin—Recommend spacing calcium supplement 4 hours after or 8 hours before administration to maximize absorption C. Ethambutol—Advise patient that this may cause dry eye, vision blurriness should be managed with lubricating drops and is not concerning D. Rifampin—Advise the patient that body fluids (sweat, tears, saliva, urine, feces) may turn orange or reddish in nature E. Unsure

Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

{{recommendationsA.Title}}

{{recommendationsB.Title}}

1. What is an appropriate initial drug treatment option for drug-sensitive pulmonary Mycobacterium avium complex disease?

2. What is an appropriate initial treatment choice for drug-sensitive pulmonary Mycobacterium kansasii infection?

3. What is an appropriate initial treatment for macrolide-sensitive Mycobacterium abscessus pulmonary infection?

5. Which adverse effect(s) do NOT belong to the antimycobacterial drug listed?

6. Which of the following is NOT one of the advantages of amikacin liposome inhalation suspension in the treatment of pulmonary nontuberculous mycobacterium (NTM) disease?

7. Which of the following therapies for nontuberculous mycobacterial disease would require use under an institutional review board or a new drug application?

8. JO is a 58-year-old female being treated for Mycobacterium abscessus infection with oral clarithromycin, intravenous (IV) amikacin, and IV cefoxitin. Baseline serum creatinine is 0.9 mg/dL. What monitoring should be recommended for the amikacin?

9. Which of the following are considered indications for therapeutic drug monitoring of oral nontuberculous mycobacterium (NTM) disease therapy?

10. Which of the following patient counseling points is inappropriate for the indicated drug therapy used in pulmonary NTM infections?

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Maintenance is scheduled for 8/7/2023 7:00 AM EST - 8:00 AM EST.

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{{recommendationsA.Title}}

{{recommendationsB.Title}}

1. What is an appropriate initial drug treatment option for drug-sensitive pulmonary Mycobacterium avium complex disease?

2. What is an appropriate initial treatment choice for drug-sensitive pulmonary Mycobacterium kansasii infection?

3. What is an appropriate initial treatment for macrolide-sensitive Mycobacterium abscessus pulmonary infection?

5. Which adverse effect(s) do NOT belong to the antimycobacterial drug listed?

6. Which of the following is NOT one of the advantages of amikacin liposome inhalation suspension in the treatment of pulmonary nontuberculous mycobacterium (NTM) disease?

7. Which of the following therapies for nontuberculous mycobacterial disease would require use under an institutional review board or a new drug application?

8. JO is a 58-year-old female being treated for Mycobacterium abscessus infection with oral clarithromycin, intravenous (IV) amikacin, and IV cefoxitin. Baseline serum creatinine is 0.9 mg/dL. What monitoring should be recommended for the amikacin?

9. Which of the following are considered indications for therapeutic drug monitoring of oral nontuberculous mycobacterium (NTM) disease therapy?

10. Which of the following patient counseling points is inappropriate for the indicated drug therapy used in pulmonary NTM infections?

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