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Clinical characteristics and treatment outcomes of patients with macrolide-resistant Mycobacterium avium complex pulmonary disease: a systematic review and meta-analysis

Authors
 Youngmok Park  ;  Eun Hye Lee  ;  Inkyung Jung  ;  Goeun Park  ;  Young Ae Kang 
Citation
 RESPIRATORY RESEARCH, Vol.20(1) : 286, 2019 
Journal Title
 RESPIRATORY RESEARCH 
ISSN
 1465-9921 
Issue Date
2019
Keywords
Clarithromycin ; Drug resistance ; Macrolides ; Mycobacterium avium complex ; Mycobacterium avium-intracellulare infection
Abstract
BACKGROUND: Macrolide is a key drug in the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD). Macrolide-resistant MAC is gaining importance, but there are little data in clinical characteristics and treatment outcomes of macrolide-resistant MAC-PD (MR-MAC-PD). METHODS: We performed a systematic review and meta-analysis of published studies reporting clinical characteristics and treatment outcomes of patients with MR-MAC-PD. Risk of bias was assessed using the modified Newcastle-Ottawa Scale. RESULTS: Nine studies (seven retrospective and two prospective) comprising 319 patients were identified through a database search. Around 73% were women, and 52% had the fibrocavitary form. Pooled sputum culture conversion rate after combined multiple antibiotics or surgical resection was 21% (95% confidence interval [CI], 14-30%), and the one-year all-cause mortality was 10% (95% CI, 5-20%). There was no significant difference in treatment outcomes between nodular bronchiectatic and fibrocavitary types. CONCLUSIONS: Even combination therapy with fluoroquinolone, aminoglycoside, and surgical resection, the treatment outcomes of MR-MAC-PD were poor. The investigation of new treatment modalities is urgent.
Files in This Item:
T201905705.pdf Download
DOI
10.1186/s12931-019-1258-9
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Park, Goeun(박고은)
Park, Youngmok(박영목) ORCID logo https://orcid.org/0000-0002-5669-1491
Lee, Eun Hye(이은혜) ORCID logo https://orcid.org/0000-0003-2570-3442
Jung, Inkyung(정인경) ORCID logo https://orcid.org/0000-0003-3780-3213
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/174847
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