BACKGROUND: The ATS (American Thoracic Society) has recommended periodic administration of multidrug therapy, including a macrolide and one or more parenteral agents or a combination of parenteral agents, over 2-4 months, for treatment of Mycobacterium abscessus pulmonary disease. However, there is little hard evidence supporting these guidelines, and treatment outcomes have not yet been reported. METHODS: We retrospectively evaluated 41 patients with M. abscessus pulmonary disease treated in accordance with ATS guidelines. These patients were treated empirically with multidrug regimens, including a macrolide and one (amikacin) or more (amikacin and cefoxitin or imipenem) parenteral agents, over several months. Treatment outcomes were defined as treatment success, failure, or default. RESULTS: Seventeen (41.5%) patients were prescribed a macrolide and one parenteral agent, and 24 (58.5%) were prescribed a macrolide and two parenteral agents. The median duration of parenteral and total antibiotic treatment were 230 days (range, 60-601 days) and 511 days (range, 164-1249 days), respectively. The treatment success, failure, and default rates were 80.5% (33/41), 12.2% (5/41), and 7.3% (3/41), respectively. Four patients relapsed over 445 days (range, 0-1443 days) of follow-up. There were no significant differences in treatment success and relapse rates between the groups receiving one and two parenteral agents. Adverse reactions developed in 18 of 41 patients (43.9%). CONCLUSIONS: Combination antibiotic therapy, including long-term (minimum 2-4 months) parenteral drugs, as recommended by the ATS, resulted in successful treatment outcomes in 80.5% of patients with M. abscessus lung disease in Korea.
BACKGROUND: The ATS (American Thoracic Society) has recommended periodic administration of multidrug therapy, including a macrolide and one or more parenteral agents or a combination of parenteral agents, over 2-4 months, for treatment of Mycobacterium abscessus pulmonary disease. However, there is little hard evidence supporting these guidelines, and treatment outcomes have not yet been reported. METHODS: We retrospectively evaluated 41 patients with M. abscessus pulmonary disease treated in accordance with ATS guidelines. These patients were treated empirically with multidrug regimens, including a macrolide and one (amikacin) or more (amikacin and cefoxitin or imipenem) parenteral agents, over several months. Treatment outcomes were defined as treatment success, failure, or default. RESULTS: Seventeen (41.5%) patients were prescribed a macrolide and one parenteral agent, and 24 (58.5%) were prescribed a macrolide and two parenteral agents. The median duration of parenteral and total antibiotic treatment were 230 days (range, 60-601 days) and 511 days (range, 164-1249 days), respectively. The treatment success, failure, and default rates were 80.5% (33/41), 12.2% (5/41), and 7.3% (3/41), respectively. Four patients relapsed over 445 days (range, 0-1443 days) of follow-up. There were no significant differences in treatment success and relapse rates between the groups receiving one and two parenteral agents. Adverse reactions developed in 18 of 41 patients (43.9%). CONCLUSIONS: Combination antibiotic therapy, including long-term (minimum 2-4 months) parenteral drugs, as recommended by the ATS, resulted in successful treatment outcomes in 80.5% of patients with M. abscessus lung disease in Korea.
Authors: Kenneth N Olivier; Pamela A Shaw; Tanya S Glaser; Darshana Bhattacharyya; Michelle Fleshner; Carmen C Brewer; Christopher K Zalewski; Les R Folio; Jenifer R Siegelman; Shamira Shallom; In Kwon Park; Elizabeth P Sampaio; Adrian M Zelazny; Steven M Holland; D Rebecca Prevots Journal: Ann Am Thorac Soc Date: 2014-01
Authors: Charles L Daley; Jonathan M Iaccarino; Christoph Lange; Emmanuelle Cambau; Richard J Wallace; Claire Andrejak; Erik C Böttger; Jan Brozek; David E Griffith; Lorenzo Guglielmetti; Gwen A Huitt; Shandra L Knight; Philip Leitman; Theodore K Marras; Kenneth N Olivier; Miguel Santin; Jason E Stout; Enrico Tortoli; Jakko van Ingen; Dirk Wagner; Kevin L Winthrop Journal: Eur Respir J Date: 2020-07-07 Impact factor: 16.671