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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Microbiol. | doi: 10.3389/fmicb.2019.01977

Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease

 Jianhui Chen1*, Lan Zhao1,  Yanhua Mao1,  Meiping Ye1, Qi Guo1, Yongjie Zhang1, Liyun Xu1, Zhemin Zhang1,  Bing Li1 and  Haiqing Chu1*
  • 1Shanghai Pulmonary Hospital, School of Medicine, Tongji University, China

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% 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.

Keywords: mycobacterium abscessus, pulmonary disease, drug, efficacy, adverse effect

Received: 19 May 2019; Accepted: 12 Aug 2019.

Copyright: © 2019 Chen, Zhao, Mao, Ye, Guo, Zhang, Xu, Zhang, Li and Chu. 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.

* Correspondence:
Mr. Jianhui Chen, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China, cjh0516@163.com
Mx. Haiqing Chu, Shanghai Pulmonary Hospital, School of Medicine, Tongji University, Shanghai, China, chu_haiqing@126.com