Volume 22, Number 3—March 2016
Dispatch
Treatment of Mycobacterium abscessus Infection
Shannon A. Novosad
, Susan E. Beekmann, Philip M. Polgreen, Kate Mackey, Kevin L. Winthrop, and M. abscessus Study Team
, Susan E. Beekmann, Philip M. Polgreen, Kate Mackey, Kevin L. Winthrop, and M. abscessus Study Team
Table 1
Initial drug regimens for pulmonary and extrapulmonary Mycobacterium abscessus infection and therapy-modifying/ending side effects*
| Regimen, no. patients | Total no. (%) patients | Therapy-modifying/ending side effect, no. (%) patients |
|---|---|---|
| Pulmonary disease, 33† | ||
| Non-IV agents | 5 (15) | 2 (40) |
| Clarithromycin, linezolid, 1 | ||
| Azithromycin, inhaled amikacin, ethambutol, rifampin, 2 | ||
| Azithromycin, inhaled amikacin, ethambutol, moxifloxacin, 1 | ||
| Azithromycin, ethambutol, linezolid, 1 | ||
| Single IV agent | 3 (9) | 1 (33) |
| Amikacin, azithromycin, levofloxacin, 1 | ||
| Tigecycline, inhaled amikacin, clofazimine, 1 | ||
| Cefoxitin, azithromycin, inhaled amikacin, 1 | ||
| Dual IV agents | 24 (73) | 15 (63) |
| Amikacin/macrolide-based regimens | 19 (57) | 13 (68) |
| Amikacin, macrolide, and 1 IV agent, in addition to amikacin | 15 (45) | 10 (67) |
| Amikacin, azithromycin, tigecycline, 7 | ||
| Amikacin, clarithromycin, cefoxitin, 2 | ||
| Amikacin, azithromycin, cefoxitin, 4 | ||
| Amikacin, azithromycin, imipenem, 2 | ||
| Amikacin, macrolide, 1 IV agent in addition to amikacin, and other oral agents | 4 (12) | 3 (75) |
| Amikacin, azithromycin, cefoxitin, moxifloxacin, 1 | ||
| Amikacin, clarithromycin, cefoxitin, moxifloxacin, 1 | ||
| Amikacin, azithromycin, imipenem, ethambutol, rifampin, 1 | ||
| Amikacin, clarithromycin, cefoxitin, other, 1 | ||
| Other amikacin-based regimens | 1 (3) | 0 |
| Amikacin, cefoxitin, 1 | ||
| Regimens without IV amikacin | 4 (12) | 2 (50) |
| Azithromycin, imipenem, tigecycline, 1 | ||
| Clarithromycin, tigecycline, imipenem, 1 | ||
| Clarithromycin, moxifloxacin, tobramycin, cefoxitin, 1 | ||
| Azithromycin, inhaled amikacin, cefoxitin, imipenem, 1 | ||
| Triple IV agents | 1 (3) | 1 (100) |
| Amikacin, macrolide, and 2 IV agent, in addition to amikacin | 1 (3) | 1 (100) |
| Amikacin, azithromycin, tigecycline, cefoxitin, 1 |
||
| Extrapulmonary disease, 21 | ||
| No IV agents | 9 (43) | 1 (11) |
| Clarithromycin, other, 1 | ||
| Clarithromycin, doxycycline, 1 | ||
| Moxifloxacin, tobramycin drops, azithromycin drops, other, 1 | ||
| Azithromycin, linezolid, 1 | ||
| Tobramycin drops, azithromycin, moxifloxacin drops, azithromycin topical, 1 | ||
| Levofloxacin, doxycycline, 1 | ||
| Ciprofloxacin, minocycline, 1 | ||
| Clarithromycin, minocycline, 1 | ||
| Azithromycin, moxifloxacin, 1 | ||
| Single IV agent | 5 (24) | 2 (40) |
| Amikacin, azithromycin, clofazimine, 1 | ||
| Cefoxitin, azithromycin, 1 | ||
| Amikacin, ethambutol, 1 | ||
| Imipenem, azithromycin, moxifloxacin, 1 | ||
| Imipenem, azithromycin, ciprofloxacin, 1 | ||
| Dual IV agents | 6 (29) | 5 (83) |
| Amikacin-based regimens | 6 (29) | 5 (83) |
| Amikacin, macrolide and one IV agent, in addition to amikacin | 5 (24) | 4 (80) |
| Amikacin, azithromycin, imipenem, 2 | ||
| Amikacin, clarithromycin, cefoxitin, 1 | ||
| Amikacin, clarithromycin, imipenem, 2 | ||
| Amikacin, macrolide,1 IV agent, in addition to amikacin, and other oral agents | 1 (5) | 1 (100) |
| Amikacin, clarithromycin, cefoxitin, moxifloxacin, linezolid, 1 | ||
| Triple IV agents | 1 (5) | 1 (100) |
| Amikacin, macrolide, 2 IV agents, in addition to amikacin, and oral agent | 1 (5) | 1 (100) |
| Amikacin, clarithromycin, imipenem, tigecycline, clofazimine, 1 |
*IV, intravenous.
†Therapy was started for 34 patients, but 1 initial regimen was unknown.
1Members of the study team are listed at the end of this article.
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