Journal
FRONTIERS IN MICROBIOLOGY
Volume 10, Issue -, Pages -Publisher
FRONTIERS MEDIA SA
DOI: 10.3389/fmicb.2019.01977
Keywords
Mycobacterium abscessus; pulmonary disease; drug; efficacy; adverse effect
Categories
Funding
- National Natural Science Foundation of China [81672063, 81800003]
- Natural Science Foundation of Shanghai Municipal Science and Technology Commission [18ZR1431600]
- Medical Guide Program of Shanghai Science and Technology Committee [18411970600, 19411969600]
- New Frontier Technology Joint Project of Municipal Hospital, Shanghai Shenkang Hospital Development Center [SHDC12017113]
- Project of Top Clinical Medicine Centers and Key Disciplines Construction in Shanghai [2017ZZ02012]
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Treatment of Mycobacterium abscessus pulmonary infection requires long-term administration of multiple antibiotics. Little is known, however, about the impact of each antibiotic on treatment outcomes. A retrospective analysis was conducted to evaluate the efficacy and adverse effects of antibiotics administered in 244 cases of M. abscessus pulmonary disease. Only 110 (45.1%) patients met the criteria for treatment success. The efficacy of treating M. abscessus pulmonary disease continues to be unsatisfactory especially for infections involving M. abscessus subsp. abscessus. Treatment with drug combinations that included amikacin [adjusted odds ratio (AOR), 3.275; 95% confidence interval (CI), 1.221-8.788], imipenem (AOR, 2.078; 95% CI, 1.151-3.753), linezolid (AOR, 2.231; 95% CI, 1.078-4.616), or tigecycline (AOR, 2.040; 95% CI, 1.079-3.857) was successful. Adverse side effects affected the majority of patients (192/244, 78.7%). Severe effects that resulted in treatment modification included: gastrointestinal distress (29/60, 48.3%) mostly caused by tigecycline, ototoxicity (14/60, 23.3%) caused by amikacin; and myelosuppression (6/60, 10%) caused mainly by linezolid. In conclusion, the success rate of treatment of M. abscessus pulmonary disease is still unsatisfactory. The administration of amikacin, imipenem, linezolid, and tigecycline correlated with increased treatment success. Adverse side effects are common due to long-term, combination antibiotic therapy. Ototoxicity, gastrointestinal distress, and myelosuppression are the most severe.
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