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Impact of Susceptibility to Injectable Antibiotics on the Treatment Outcomes of <i>Mycobacterium abscessus</i> Pulmonary Disease
Resource type
Journal Article
Authors/contributors
- Park, Youngmok (Author)
- Park, Yea Eun (Author)
- Jhun, Byung Woo (Author)
- Park, Jimyung (Author)
- Kwak, Nakwon (Author)
- Jo, Kyung-Wook (Author)
- Yim, Jae-Joon (Author)
- Shim, Tae Sun (Author)
- Kang, Young Ae (Author)
Title
Impact of Susceptibility to Injectable Antibiotics on the Treatment Outcomes of <i>Mycobacterium abscessus</i> Pulmonary Disease
Abstract
Background. Current guidelines recommend a susceptibility-based regimen for Mycobacterium abscessus subspecies abscessus pulmonary disease (MAB-PD), but the evidence is weak. We aimed to investigate the association between treatment outcomes and in vitro drug susceptibility to injectable antibiotics in MAB-PD patients.
Methods. We enrolled MAB-PD patients treated with intravenous amikacin and beta-lactams for ≥4 weeks at 4 referral hospitals in Seoul, South Korea. Culture conversion and microbiological cure at 1 year were evaluated based on susceptibility to injectable antibiotics among patients treated with those antibiotics for ≥2 weeks.
Results. A total of 82 patients were analyzed. The mean age was 58.7 years, and 65.9% were women. Sputum culture conversion and microbiological cure were achieved in 52.4% and 41.5% of patients, respectively. Amikacin was the most common agent to which the M. abscessus subspecies abscessus isolates were susceptible (81.7%); 9.8% and 24.0% of the isolates were resistant to cefoxitin and imipenem, respectively. The clarithromycin-inducible resistance (IR) group (n = 65) had a lower microbiological cure rate than the clarithromycin-susceptible group (35.4% vs 64.7%). The treatment outcomes appeared to be similar regardless of in vitro susceptibility results with regard to intravenous amikacin, cefoxitin, imipenem, and moxifloxacin. In the subgroup analysis of the clarithromycin-IR group, the treatment outcomes did not differ according to antibiotic susceptibility.
Conclusions. We did not find evidence supporting the use of susceptibility-based treatment with intravenous amikacin and beta-lactams in patients with MAB-PD. Further research is required.
Publication
Open Forum Infectious Diseases
Date
2021-06-01
Volume
8
Issue
6
Pages
ofab215
Accessed
5/13/23, 3:06 PM
ISSN
2328-8957
Language
en
Library Catalog
DOI.org (Crossref)
Citation
Park, Y., Park, Y. E., Jhun, B. W., Park, J., Kwak, N., Jo, K.-W., Yim, J.-J., Shim, T. S., & Kang, Y. A. (2021). Impact of Susceptibility to Injectable Antibiotics on the Treatment Outcomes of Mycobacterium abscessus Pulmonary Disease. Open Forum Infectious Diseases, 8(6), ofab215. https://doi.org/10.1093/ofid/ofab215
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