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Treatment outcome of continuation of intravenous amikacin for Mycobacterium abscessus pulmonary disease with a persistent culture positivity after the treatment initiation

Authors
 Yea Eun Park  ;  Seo Young Park  ;  Byung Woo Jhun  ;  Youngmok Park  ;  Young Ae Kang  ;  Jimyung Park  ;  Nakwon Kwak  ;  Jae-Joon Yim  ;  Tae Sun Shim  ;  Kyung-Wook Jo 
Citation
 JOURNAL OF INFECTION AND CHEMOTHERAPY, Vol.28(8) : 1098-1104, 2022-08 
Journal Title
JOURNAL OF INFECTION AND CHEMOTHERAPY
ISSN
 1341-321X 
Issue Date
2022-08
MeSH
Amikacin ; Anti-Bacterial Agents ; Humans ; Lung Diseases* / drug therapy ; Lung Diseases* / microbiology ; Microbial Sensitivity Tests ; Mycobacterium Infections, Nontuberculous* / drug therapy ; Mycobacterium Infections, Nontuberculous* / microbiology ; Mycobacterium abscessus* ; Retrospective Studies ; Treatment Outcome
Keywords
Amikacin ; Microbiological cure ; Mycobacterium abscessus pulmonary Disease ; Treatment duration
Abstract
Introduction: Whether prolonged intravenous amikacin treatment would lead to better treatment results in patients with Mycobacterium abscessus subspecies abscessus (M. abscessus) pulmonary disease (PD) is unknown. We investigated the efficacy of continued amikacin treatment for the microbiological outcome of M. abscessus PD patients with persistent culture positivity after treatment initiation.

Methods: We retrospectively evaluated 62 patients with M. abscessus PD who were treated with intravenous amikacin and beta-lactams along with a macrolide-based regimen at 3 tertiary referral centers in South Korea. The intravenous antibiotic treatment duration was determined by the attending physician.

Results: The median treatment durations with amikacin and beta-lactam in the 62 patients were 25.1 and 8.2 weeks, respectively. The overall microbiological cure rate was 29.0%. Among the 62 patients, 44 showed persistent culture positivity at 8 weeks after treatment with an amikacin-containing multidrug regimen. The median parenteral amikacin treatment duration after 8 weeks in these patients was 18.0 weeks. The conditional probability of microbiological cure with continuation of the amikacin-containing regimen in these patients was 18.2% (95% confidence interval 8.2-32.7). Additionally, the conditional probability of microbiological cure in the 34 patients with persistent culture positivity at 12 weeks was 8.8% (95% confidence interval 1.9-23.7). After 16 weeks, the conditional probability of microbiological cure decreased further, reaching 0% at 28 weeks after treatment initiation.

Conclusion: The continuation of intravenous amikacin therapy was usually not followed by culture conversion in M. abscessus PD patients with persistent sputum culture positivity after treatment initiation.
Full Text
https://www.sciencedirect.com/science/article/pii/S1341321X22001052
DOI
10.1016/j.jiac.2022.03.026
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Young Ae(강영애) ORCID logo https://orcid.org/0000-0002-7783-5271
Park, Youngmok(박영목) ORCID logo https://orcid.org/0000-0002-5669-1491
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/196691
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