M. fortuitum, M. chelonae, and M. abscessus are resistant to the antituberculous agents. Depending on the susceptibility pattern, treatment with amikacin, ciprofloxacin, cefoxitin, and clarithromycin is recommended (Table 4).
For treatment of pulmonary disease because of other NTM, see Table 4.
Table 4 Treatment of NTM
M. avium complex
M. fortuitum, M. chelonae, and M. abscessus M. malmoense
Clarithromycin (500 mg, BD) + ethambutol (15 mg/kg) + rifampicin (600 mg) or rifabutin (300 mg) Rifampicin (600 mg) + isoniazid (300 mg) +ethambutol (15 mg/kg) Clarithromycin (500 mg, BD) or minocycline or doxycycline (100 mg) or rifampicin (600 mg) +ethambutol (15 mg/kg) Amikacin (10-15 mg/kg) + cefoxitin (12 mg/day) or clarithromycin (500 mg, BD) Clarithromycin (500 mg, BD) + ethambutol (15 mg/kg) + rifabutin (300 mg) + streptomycin Isoniazid, rifampicin, ethambutol, and streptomycin
Culture-negative for 12 months. In HIV-positive patients, treatment is for life.
18 months, culture negative for 12 months
Cutaneous and disseminated-pulmonary—2 weeks 18-24 months
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.