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Respir Med. 2011 May;105(5):781-7. doi: 10.1016/j.rmed.2010.12.012. Epub 2011 Jan 5.

Outcomes in patients with Mycobacterium abscessus pulmonary disease treated with long-term injectable drugs.

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1
Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Poongnap-dong, Songpa-gu, Seoul 138-736, South Korea.

Abstract

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.

PMID:
21211956
DOI:
10.1016/j.rmed.2010.12.012
[Indexed for MEDLINE]
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