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People with cystic fibrosis (CF) often take antibiotics, including the macrolide azithromycin, for long periods to help manage their condition. But some doctors feared that chronic macrolide use might predispose people with CF to nontuberculous mycobacterial (NTM) infections. To examine the relationship between chronic macrolide therapy and NTM, researchers from NIAID reviewed health information about 27,112 people in the CF Patient Registry, of whom 5,403 were tested for NTM infections in 2010 and 2011. Contrary to expectations, the 191 people newly infected with NTM in 2011 were less likely to have taken azithromycin in the preceding year. Among adults and adolescents, those with the greatest number of years on chronic macrolide therapy were the least likely to develop new NTM infections.
However, the researchers caution, if a person does become infected with NTM, he or she should not receive macrolide monotherapy because of the risk that NTM will quickly develop resistance to the single drug. To avoid macrolide-resistant NTM, the scientists suggest that all CF patients be regularly tested for NTM infection. The research was led by D. Rebecca Prevots, Ph.D., of NIAID’s Laboratory of Clinical Infectious Diseases, and was published online in the American Journal of Respiratory and Critical Care Medicine.