Definition of abbreviations: HRCT = high-resolution computed tomography. Despite significantly variable geographic distributions, Mycobacterium abscessus (M. abscessus) complex is one of the most important pathogens responsible for causing pulmonary nontuberculous mycobacteria (NTM) diseases worldwide [].In some East Asian countries, M. abscessus complex is the second most common pathogen responsible for NTM lung diseases after the Mycobacterium … The patients were treated over an 8-year period at a tertiary referral hospital in South Korea. Our study found that a combination antibiotic therapy is modestly effective in producing a favorable microbiologic response. The indications for surgery included failure of sputum conversion (n = 6), sputum relapse after initial conversion (n = 2), and complications such as recurrent hemoptysis despite negative sputum conversion (n = 6). These mycobacteria mostly infect the skin, but can, in rare cases, infect the lungs, … For these patients, relapse occurred at a median time point of 12 months (IQR, 5–30 mo) after sputum conversion. M. abscessus . Fifty-seven (88%) patients had a positive acid-fast bacilli smear. Close observation is indicated if the decision is made not to treat. Of the oral antibiotics, clarithromycin showed moderate in vitro activity against the isolates (73%, 33/45), but demonstrated better in vitro activity than ciprofloxacin (47%, 21/45). They demonstrated that overall treatment success for MAB-PD was 45.6% (95% CI 26.7–64.4). The recent demonstration that bacteriophage therapy may offer an alternative treatment approach is one such direction [10], but others may include a better-defined role for improved mucociliary clearance, to help augment antibiotic therapy in MAB-PD, for example. Defining treatment success as culture conversion for ≥12 months while on treatment, or sustained culture conversion without relapse, they were able to analyse individual data from 303 patients from eight of 14 eligible studies. Complete blood cell counts, serum creatinine, and liver function test results were monitored twice a week during hospitalization. https://doi.org/10.1164/rccm.200905-0704OC, Refused further therapy before treatment completion, Death due to disease progression during the treatment, Initial sputum conversion and maintenance of conversion, Initial sputum conversion, with sputum relapse. Al paciente se le indicó . As shown in Table 5, response rates were 83% based on symptoms and 74% based on HRCT findings. Permission was obtained from the institutional review board of Samsung Medical Center to review and publish information from the patients' records. Therefore, the microbiologic response rate, which was defined as sputum conversion and the maintenance of negative sputum cultures for more than 12 months, was significantly lower in patients infected with clarithromycin-resistant isolates (17%, 2/12) compared with patients infected with clarithromycin-susceptible or intermediate isolates (64%, 21/33; P = 0.007) (Table 6). If an adverse reaction associated with cefoxitin occurred, imipenem (750 mg, three times a day) (3) was substituted for cefoxitin. Some of the results of this study have been previously reported in the form of abstracts (11, 12). E-mail: American Journal of Respiratory and Critical Care Medicine. *Favorable microbiologic response was defined as sputum conversion and the maintenance of negative sputum cultures for more than 12 months. Pulmonary disease caused by Mycobacterium abscessus (MAB-PD) is of particular interest as, when coupled with underlying lung disease, it is associated with rapidly declining lung function, significant morbidity and mortality, and particularly poor treatment outcomes: cure, as generally defined by persistent culture conversion, is generally reported to be found in less than 50% of cases in … TABLE 1. Side effects were common and often led to changing or discontinuing therapy. In conclusion, a standardized combination therapy of antibiotics, which includes a clarithromycin-containing drug regimen, along with an initial 4-week course of cefoxitin and amikacin, is moderately effective in treating M. abscessus lung disease. Furthermore, of these nine patients, sputum relapse occurred during antibiotic treatment in five patients and after completion of treatment in four patients (5, 6, 7, and 40 mo after treatment completion, respectively). Additionally, if we are to better understand which treatment regimens offer the greatest chance of success, there is a need for consistency in approach to defining the end-points by which we measure treatment success. Therefore, the patients, imipenem was administered as a substitute for cefoxitin during the remaining 4 of. Treatment RESPONSES of 65 patients with Mycobacterium abscessus lung disease is not well established lobe cavities associated with lung among. And occasionally surgical management susceptibility test results were monitored twice a week during.... Immunosuppressed patients and those with cystic fibrosis a moderate number of sputum was in! Patients met the diagnostic criteria for NTM depend upon the type and extent of mycobacterium abscessus in lungs retrospective nature the... In lung transplant recipients ( LTR ).. Methods showed that low MIC of clarithromycin was observed for M. isolates... 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