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Published on: August 16, 2021
Pharmacokinetic/pharmacodynamic-based treatment of disseminated Mycobacterium avium
Devyani Deshpande1, Tawanda Gumbo
1Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, TX 75390-9113, USA.
Abstract:
Disseminated Mycobacterium avium complex (MAC) is treated with a macrolide and ethambutol. However, the kill rates are extremely slow so that therapy takes many months to years to achieve and even then more than 40% of patients are not completely cured. Recent studies have demonstrated that assays that detect extracellular MAC have a limited predictive value. Antibiotics kill at a much slower and more disappointing rate against bacilli within macrophages. Use of pharmacodynamic/pharmacokinetic models has resulted in design of new doses and dosing schedules for disseminated MAC, as well as new susceptibility breakpoints for ethambutol and moxifloxacin.
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