Tuberc Respir Dis.  2007 Feb;62(2):98-104. 10.4046/trd.2007.62.2.98.

Long-term Outcome of Treatment of Mycobacterium Abscessus Pulmonary Disease

• Jo KU
• Park SJ
• Hong SC
• Oh YM
• Lee SD
• Kim WS
• Kim DS
• Kim WD
• Shim TS

• KMID: 2114595
• DOI: http://doi.org/10.4046/trd.2007.62.2.98

Abstract

BACKGROUND: Although there is an increasing incidence of Mycobacterium abscessus pulmonary disease in Korea, the optimal therapeutic regimen has not yet been established and there are no reports of the long-term treatment outcomes. This study examined the long-term treatment outcomes of M. abscessus pulmonary disease.
METHODS
Twenty-nine patients diagnosed with M. abscessus pulmonary according to the American Thoracic Society criteria and treated from January 1996 to December 2003 were enrolled in ghis study. The clinical characteristics, radiological findings, treatment outcome, and follow up data were analyzed retrospectively.
RESULTS
The mean age of the 29 patients was 56.1 (+/- 13.6) years and there was a female (22/29) dominance. The chest radiography revealed the nodular bronchiectatic type to be dominant (69%, 20/29). Twenty-seven (93.1%) were prescribed clarithromycin-containing regimens, and injectable drugs, mainly aminoglycosides, were included in the regimen of nineteen patients. The most predominant regimen (48.3%) consisted of clarithromycin and amikacin. The treatment success, failure, and default were achieved in 19(65.5%), 9(31.0%), and 1(3.4%), respectively. The median duration to culture conversion was 42 days (range 15-362) and the median duration of treatment in the success group was 543 days (range 176-1,160). An adjunctive surgical resection was performed in five patients, which resulted in treatment success in two patients. After the completion of treatment, nineteen patients were followed up for a median duration of 931 days (range 230-2,294). Only one (5.3%) patient relapsed 45 days after completing treatment.
CONCLUSION
Treatment with clarithromycin-containing regimens resulted in a successful treatment in approximately two thirds of patients with M. abscessus pulmonary disease. The long-term relapse rate was also quite low.

Keyword

Mycobacterium abscessus pulmonary disease; Treatment outcome; Long term result

MeSH Terms

Amikacin
Aminoglycosides
Clarithromycin
Female
Follow-Up Studies
Humans
Incidence
Korea
Lung Diseases*
Mycobacterium*
Radiography
Recurrence
Retrospective Studies
Thorax
Treatment Outcome
Amikacin
Aminoglycosides
Clarithromycin

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