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

Jiwon Lyu1, Hang Jea Jang, Jin Woo Song

  • 1Division 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.

Respiratory Medicine
|January 8, 2011
PubMed
Abstract

Insights

Treatment for Mycobacterium abscessus lung disease using American Thoracic Society guidelines showed an 80.5% success rate. This multidrug therapy, including macrolides and parenteral agents, offers effective outcomes for this rare pulmonary infection.

Area of Science:

  • Pulmonology
  • Infectious Diseases
  • Microbiology

Background:

  • The American Thoracic Society (ATS) recommends multidrug therapy for Mycobacterium abscessus pulmonary disease.
  • Current guidelines suggest 2-4 months of treatment with macrolides and parenteral agents.
  • Evidence supporting these ATS guidelines and reported outcomes are limited.

Purpose of the Study:

  • To evaluate the effectiveness of ATS-recommended multidrug therapy for Mycobacterium abscessus pulmonary disease.
  • To report treatment outcomes, including success, failure, and relapse rates.
  • To analyze adverse reactions associated with the treatment regimen.

Main Methods:

  • Retrospective evaluation of 41 patients with M. abscessus pulmonary disease treated per ATS guidelines.
  • Empirical multidrug regimens included a macrolide plus one (amikacin) or two (amikacin and cefoxitin/imipenem) parenteral agents.
  • Treatment outcomes categorized as success, failure, or default.

Main Results:

  • 80.5% treatment success rate (33/41 patients).
  • Median parenteral treatment duration was 230 days; total antibiotic duration was 511 days.
  • Adverse reactions occurred in 43.9% of patients; no significant difference in success between one vs. two parenteral agents.

Conclusions:

  • ATS-recommended combination antibiotic therapy, including long-term parenteral drugs, achieved successful outcomes in 80.5% of M. abscessus lung disease patients in Korea.
  • The findings support the efficacy of current ATS guidelines for treating this challenging pulmonary infection.
  • Long-term treatment with macrolides and parenteral agents is crucial for successful management.

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