Yong-Soo Kwon1, Adrah Levin2, Shannon H Kasperbauer3, Gwen A Huitt3, Charles L Daley4. 1. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, South Korea; Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA. Electronic address: yskwon@jnu.ac.kr. 2. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA. 3. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA; Department of Medicine, University of Colorado, Denver, CO, USA. 4. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, CO, USA; Department of Medicine, University of Colorado, Denver, CO, USA. Electronic address: daleyc@njhealth.org.
Abstract
PURPOSE: Mycobacterium abscessus disease is one of the most difficult mycobacterial infections to cure, as the bacterium is highly resistant to conventional antibiotics. The purpose of this study was to evaluate the efficacy and safety of tigecycline treatment of M. abscessus disease. PROCEDURE: We performed retrospective chart reviews of patients with M. abscessus disease receiving tigecycline-containing regimens at National Jewish Health from January 2009 to December 2017. MAIN FINDINGS: Among the 35 patients, pulmonary disease was the most common presentation of M. abscessus disease (n = 29, 82.9%). Of those receiving tigecycline treatment, 17.4% (4/23) showed microbiological improvement (≥2 consecutive negative sputum cultures), while 86.2% (25/29) and 59.3% (16/27) showed symptomatic and radiological improvements, respectively. The rate of dose reduction or discontinuation of tigecycline owing to adverse drug reactions was 57.1% (20/35) at a median of 56.5 days (IQR 10.8-122.3). The most common adverse drug reactions were gastrointestinal side effects, including nausea, vomiting, and diarrhea. CONCLUSIONS: Tigecycline-containing regimens for M. abscessus disease have a high rate of symptomatic and radiological improvement. However, considering the poor microbiological response and the common adverse effects, selection of patients for tigecycline treatment and monitoring for adverse drug reactions should be performed carefully.
PURPOSE: Mycobacterium abscessus disease is one of the most difficult mycobacterial infections to cure, as the bacterium is highly resistant to conventional antibiotics. The purpose of this study was to evaluate the efficacy and safety of tigecycline treatment of M. abscessus disease. PROCEDURE: We performed retrospective chart reviews of patients with M. abscessus disease receiving tigecycline-containing regimens at National Jewish Health from January 2009 to December 2017. MAIN FINDINGS: Among the 35 patients, pulmonary disease was the most common presentation of M. abscessus disease (n = 29, 82.9%). Of those receiving tigecycline treatment, 17.4% (4/23) showed microbiological improvement (≥2 consecutive negative sputum cultures), while 86.2% (25/29) and 59.3% (16/27) showed symptomatic and radiological improvements, respectively. The rate of dose reduction or discontinuation of tigecycline owing to adverse drug reactions was 57.1% (20/35) at a median of 56.5 days (IQR 10.8-122.3). The most common adverse drug reactions were gastrointestinal side effects, including nausea, vomiting, and diarrhea. CONCLUSIONS:Tigecycline-containing regimens for M. abscessus disease have a high rate of symptomatic and radiological improvement. However, considering the poor microbiological response and the common adverse effects, selection of patients for tigecycline treatment and monitoring for adverse drug reactions should be performed carefully.
Authors: Oliver W Meldrum; Kylie B R Belchamber; Kiarina D Chichirelo-Konstantynovych; Katie L Horton; Tetyana V Konstantynovych; Merete B Long; Melissa J McDonnell; Lidia Perea; Alberto L Garcia-Basteiro; Michael R Loebinger; Raquel Duarte; Holly R Keir Journal: ERJ Open Res Date: 2022-05-23
Authors: Andrew Burke; Daniel Smith; Chris Coulter; Scott C Bell; Rachel Thomson; Jason A Roberts Journal: Clin Pharmacokinet Date: 2021-05-13 Impact factor: 5.577