Document Detail


Antibiotic treatment of Mycobacterium abscessus lung disease: a retrospective analysis of 65 patients.
MedLine Citation:
PMID:  19661243     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
RATIONALE: The optimal therapeutic regimen and duration of treatment for Mycobacterium abscessus lung disease is not well established. OBJECTIVES: To assess the efficacy of a standardized combination antibiotic therapy for the treatment of M. abscessus lung disease. METHODS: Sixty-five patients (11 males, 55 females, median age 55 yr) with M. abscessus lung disease were treated with clarithromycin, ciprofloxacin, and doxycycline, together with an initial regimen of amikacin and cefoxitin for the first 4 weeks of hospitalization. MEASUREMENTS AND MAIN RESULTS: Treatment response rates were 83% for symptoms and 74% for high-resolution computed tomography. Sputum conversion and maintenance of negative sputum cultures for more than 12 months was achieved in 38 (58%) patients. These rates were significantly lower in patients whose isolates were resistant to clarithromycin (17%, 2/12) compared with those whose isolates were susceptible or intermediate to clarithromycin (64%, 21/33; P = 0.007). Neutropenia and thrombocytopenia associated with cefoxitin developed in 33 (51%) and 4 (6%) patients, respectively. Drug-induced hepatotoxicity occurred in 10 (15%) patients. Because of these adverse reactions, cefoxitin was discontinued in 39 (60%) patients after treatment for a median of 22 days. CONCLUSIONS: Standardized combination antibiotic therapy was moderately effective in treating M. abscessus lung disease. However, frequent adverse reactions and the potential for long-duration hospitalization are important problems that remain to be solved.
Authors:
Kyeongman Jeon; O Jung Kwon; Nam Yong Lee; Bum-Joon Kim; Yoon-Hoh Kook; Seung-Heon Lee; Young Kil Park; Chang Ki Kim; Won-Jung Koh
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-08-06
Journal Detail:
Title:  American journal of respiratory and critical care medicine     Volume:  180     ISSN:  1535-4970     ISO Abbreviation:  Am. J. Respir. Crit. Care Med.     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-21     Completed Date:  2009-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421642     Medline TA:  Am J Respir Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  896-902     Citation Subset:  AIM; IM    
Affiliation:
Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Adult
Amikacin / adverse effects,  therapeutic use
Anti-Bacterial Agents / adverse effects,  therapeutic use*
Anti-Infective Agents / therapeutic use
Cefoxitin / adverse effects,  therapeutic use
Ciprofloxacin / adverse effects,  therapeutic use
Clarithromycin / adverse effects,  therapeutic use
Doxycycline / adverse effects,  therapeutic use
Drug Therapy, Combination
Drug-Induced Liver Injury / etiology
Female
Humans
Liver / drug effects
Lung / drug effects,  microbiology,  radiography
Lung Diseases / drug therapy*,  microbiology
Male
Middle Aged
Mycobacteria, Atypical / drug effects,  isolation & purification
Mycobacterium Infections, Atypical / drug therapy*,  microbiology
Neutropenia / chemically induced
Retrospective Studies
Sputum / drug effects,  microbiology
Thrombocytopenia / chemically induced
Tomography, X-Ray Computed
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Anti-Infective Agents; 35607-66-0/Cefoxitin; 37517-28-5/Amikacin; 564-25-0/Doxycycline; 81103-11-9/Clarithromycin; 85721-33-1/Ciprofloxacin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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