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Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease
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...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Frontiers Media S.A.
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716072/ https://www.ncbi.nlm.nih.gov/pubmed/31507579 http://dx.doi.org/10.3389/fmicb.2019.01977 |
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author | Chen, Jianhui Zhao, Lan Mao, Yanhua Ye, Meiping Guo, Qi Zhang, Yongjie Xu, Liyun Zhang, Zhemin Li, Bing Chu, Haiqing |
author_facet | Chen, Jianhui Zhao, Lan Mao, Yanhua Ye, Meiping Guo, Qi Zhang, Yongjie Xu, Liyun Zhang, Zhemin Li, Bing Chu, Haiqing |
author_sort | Chen, Jianhui |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6716072 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-67160722019-09-10 Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease Chen, Jianhui Zhao, Lan Mao, Yanhua Ye, Meiping Guo, Qi Zhang, Yongjie Xu, Liyun Zhang, Zhemin Li, Bing Chu, Haiqing Front Microbiol Microbiology 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. Frontiers Media S.A. 2019-08-23 /pmc/articles/PMC6716072/ /pubmed/31507579 http://dx.doi.org/10.3389/fmicb.2019.01977 Text en Copyright © 2019 Chen, Zhao, Mao, Ye, Guo, Zhang, Xu, Zhang, Li and Chu. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Microbiology Chen, Jianhui Zhao, Lan Mao, Yanhua Ye, Meiping Guo, Qi Zhang, Yongjie Xu, Liyun Zhang, Zhemin Li, Bing Chu, Haiqing Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title | Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title_full | Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title_fullStr | Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title_full_unstemmed | Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title_short | Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease |
title_sort | clinical efficacy and adverse effects of antibiotics used to treat mycobacterium abscessus pulmonary disease |
topic | Microbiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716072/ https://www.ncbi.nlm.nih.gov/pubmed/31507579 http://dx.doi.org/10.3389/fmicb.2019.01977 |
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