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Clofazimine-Containing Regimen for the Treatment of Mycobacterium abscessus Lung Disease

Authors
 Bumhee Yang  ;  Byung Woo Jhun  ;  Seong Mi Moon  ;  Hyun Lee  ;  Hye Yun Park  ;  Kyeongman Jeon  ;  Dae Hun Kim  ;  Su-Young Kim  ;  Sung Jae Shin  ;  Charles L. Daley  ;  Won-Jung Koh 
Citation
 Antimicrobial Agents and Chemotherapy, Vol.61(6) : e02052-16, 2017 
Journal Title
 Antimicrobial Agents and Chemotherapy 
ISSN
 0066-4804 
Issue Date
2017
MeSH
Clofazimine/therapeutic use* ; Drug Therapy, Combination ; Lung Diseases/microbiology* ; Microbial Sensitivity Tests ; Mycobacterium abscessus/drug effects* ; Mycobacterium abscessus/pathogenicity ; Nontuberculous Mycobacteria/drug effects ; Nontuberculous Mycobacteria/pathogenicity ; Retrospective Studies ; Treatment Outcome
Keywords
Mycobacterium abscessus ; clofazimine ; nontuberculous mycobacteria ; treatment outcome
Abstract
Patients with lung disease caused by Mycobacterium abscessus subsp. abscessus (here M. abscessus) typically have poor treatment outcomes. Although clofazimine (CFZ) has been increasingly used in the treatment of M. abscessus lung disease in clinical practice, there are no reported data on its effectiveness for this disease. This study sought to evaluate the clinical efficacy of a CFZ-containing regimen for the treatment of M. abscessus lung disease. We performed a retrospective review of the medical records of 42 patients with M. abscessus lung disease who were treated with CFZ-containing regimens between November 2013 and January 2015. CFZ was administered in combination with other antibiotics as an initial antibiotic regimen in 15 (36%) patients (initial treatment group), and it was added to an existing antibiotic regimen for refractory M. abscessus lung disease in 27 (64%) patients (salvage treatment group). Overall, there was an 81% treatment response rate based on symptoms and a 31% response rate based on radiographic findings. Conversion to culture-negative sputum samples was achieved in 10 (24%) patients after CFZ-containing antibiotic treatment, and during treatment, there were significant decreases in the positivity of semiquantitative sputum cultures for acid-fast bacilli in both the initial (P = 0.018) and salvage (P = 0.001) treatment groups. Our study suggests that CFZ-containing regimens may improve treatment outcomes in patients with M. abscessus lung disease and that a prospective evaluation of CFZ in M. abscessus lung disease is warranted.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/160884
DOI
10.1128/AAC.02052-16
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Microbiology (미생물학교실)
Yonsei Authors
신성재(Shin, Sung Jae)
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