Standardized Combination Antibiotic Treatment of Mycobacterium avium Complex Lung Disease.
10.3349/ymj.2010.51.6.888
- Author:
Yun Su SIM
1
;
Hye Yun PARK
;
Kyeongman JEON
;
Gee Young SUH
;
O Jung KWON
;
Won Jung KOH
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. wjkoh@skku.edu
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Atypical mycobacteria;
lung diseases;
Mycobacterium avium complex;
treatment outcomes
- MeSH:
Aged;
Anti-Bacterial Agents/*therapeutic use;
Clarithromycin/therapeutic use;
Drug Therapy, Combination/*methods;
Ethambutol/therapeutic use;
Female;
Humans;
Lung Diseases/*drug therapy/*microbiology;
Male;
Middle Aged;
Mycobacterium Infections/*drug therapy;
Mycobacterium avium/*metabolism;
Retrospective Studies;
Rifampin/therapeutic use;
Streptomycin/therapeutic use;
Treatment Outcome
- From:Yonsei Medical Journal
2010;51(6):888-894
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The optimal treatment regimen for Mycobacterium avium complex (MAC) lung disease has not yet been fully established. We evaluated the efficacy of standardized combination antibiotic therapy and the factors that might affect unfavorable microbiologic responses in patients with MAC pulmonary disease. MATERIALS AND METHODS: This retrospective study reviewed data from 96 patients (56 females; median age 59 years) treated with newly diagnosed MAC lung disease between January 2003 and December 2006. RESULTS: All patients received standardized combination antibiotic therapy, consisting of clarithromycin, rifampicin, and ethambutol. Streptomycin was additionally given in 72 patients (75%) for a median duration of 4.5 months. The overall favorable microbiologic response rate was 79% (76/96); 20 patients (21%) had unfavorable microbiologic responses, including failure to sputum conversion (n = 13), relapse (n = 3), and MAC-related death (n = 4). A positive sputum acid-fast bacillus smear at the start of treatment was an independent predictor of an unfavorable microbiologic response. CONCLUSION: Standardized combination antibiotic therapy consisting of clarithromycin, rifampicin, and ethambutol with or without initial use of streptomycin is effective in treating patients with newly diagnosed MAC lung disease.
