Related Experiment Video

Updated: May 21, 2025

Use of Artificial Sputum Medium to Test Antibiotic Efficacy Against Pseudomonas aeruginosa in Conditions More Relevant to the Cystic Fibrosis Lung
07:46

Use of Artificial Sputum Medium to Test Antibiotic Efficacy Against Pseudomonas aeruginosa in Conditions More Relevant to the Cystic Fibrosis Lung

Published on: June 5, 2012

32.8K

Effects of Amikacin Liposome Inhalation Suspension and Amikacin Resistance Development in Patients With Refractory

Yu Kurahara1,2,3, Shiomi Yoshida3, Asami Osugi4

  • 1Department of Internal Medicine, NHO Kinki Chuo Chest Medical Center, Osaka, Japan.

Open Forum Infectious Diseases
|March 20, 2025
PubMed
Abstract

Insights

Amikacin liposome inhalation suspension (ALIS) shows higher efficacy in noncavitary nodular bronchiectatic (NC-NB) compared to cavitary pulmonary disease. Acquired amikacin (AMK) resistance during treatment may limit therapeutic options for refractory Mycobacterium avium complex pulmonary disease (MAC-PD).

Area of Science:

  • Pulmonary Medicine
  • Infectious Diseases
  • Pharmacology

Background:

  • Amikacin liposome inhalation suspension (ALIS) is crucial for treating refractory Mycobacterium avium complex pulmonary disease (MAC-PD).
  • Microbiological efficacy of ALIS across different MAC-PD subtypes is not well-established.
  • The emergence and mechanisms of amikacin (AMK) resistance during ALIS therapy require further investigation.

Purpose of the Study:

  • To evaluate the microbiological efficacy of ALIS in patients with refractory MAC-PD, stratified by disease subtype.
  • To determine the frequency and potential mechanisms of AMK resistance developing during ALIS treatment.
  • To identify predictors of treatment response and persistent infection in refractory MAC-PD.

Main Methods:

  • Retrospective analysis of 44 refractory MAC-PD patients treated with ALIS adjunctively for at least 6 months.
  • Investigation of sputum culture conversion rates, focusing on differences between noncavitary nodular bronchiectatic (NC-NB) and cavitary subtypes.
  • Analysis of gene expression and the incidence of AMK resistance (MIC ≥128 µg/mL), including identification of specific mutations (e.g., in *rrs*).

Main Results:

  • Overall sputum culture conversion was 56.8%, with significantly higher rates in the NC-NB subtype (84.2%) compared to the cavitary subtype (36.0%).
  • Patients with high C-reactive protein (CRP), cavitary disease, and clarithromycin (CLM) resistance showed a significantly higher risk of persistent positive cultures.
  • Amikacin resistance was observed in 15.9% of patients, with *rrs* mutations identified in 71.4% of resistant isolates.

Conclusions:

  • ALIS-containing regimens demonstrate superior culture conversion rates in NC-NB MAC-PD compared to cavitary forms.
  • High CRP levels, cavitary disease, and CLM resistance are predictors of persistent microbiological positivity.
  • Acquired AMK resistance during ALIS therapy poses a significant challenge, potentially limiting future treatment options for refractory MAC-PD.
Keywords:
Mycobacterium avium complexamikacin liposome inhalation suspensionamikacin resistancenoncavitary-nodular bronchiectaticrrs mutation

More Related Videos

Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung09:26

Antibiotic Efficacy Testing in an Ex vivo Model of Pseudomonas aeruginosa and Staphylococcus aureus Biofilms in the Cystic Fibrosis Lung

Published on: January 22, 2021

6.8K
A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii09:17

A Robust Pneumonia Model in Immunocompetent Rodents to Evaluate Antibacterial Efficacy against S. pneumoniae, H. influenzae, K. pneumoniae, P. aeruginosa or A. baumannii

Published on: January 2, 2017

14.6K

Related Concept Videos

Pulmonary Tuberculosis V01:28

Pulmonary Tuberculosis V

Medical management of tuberculosis (TB) patients involves a comprehensive approach that includes diagnosis, treatment, and monitoring. The specific strategies can vary depending on the type of tuberculosis (latent or active), the patient's overall health status, and other considerations.
Latent tuberculosis infection occurs when TB bacteria are present in a person's body, but are not causing illness or symptoms. It is not contagious, and preventive treatment is crucial to avoid the...
159
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
3.7K