Clinical efficacy and safety of multidrug therapy including thrice weekly intravenous amikacin administration for Mycobacterium abscessus pulmonary disease in outpatient settings: a case series.
BMC Infect Dis. 2016 Aug 9;16:396.
Namkoong H1,2,3, Morimoto K4, Nishimura T5, Tanaka H1, Sugiura H6, Yamada Y6, Kurosaki A7, Asakura T1, Suzuki S1, Fujiwara H8, Yagi K1, Ishii M1, Tasaka S1, Betsuyaku T1, Hoshino Y9, Kurashima A4, Hasegawa N10.
1Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Tokyo, Japan.
2Japan Society for the Promotion of Science, Tokyo, Japan.
3Department of Pulmonary Medicine, Eiju General Hospital, Tokyo, Japan.
4Respiratory Disease Center, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
5Keio University Health Center, Tokyo, Japan.
6Department of Diagnostic Radiology, Keio University School of Medicine, Tokyo, Japan.
7Department of Diagnostic Radiology, Fukujuji Hospital, Japan Anti-Tuberculosis Association, Tokyo, Japan.
8Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
9Leprosy Research Center, National Institute of Infectious Diseases, Tokyo, Japan.
10Center for Infectious Diseases and Infection Control, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan. firstname.lastname@example.org
Mycobacterium abscessus (M. abscessus) pulmonary disease is a refractory chronic infectious disease. Options for treating M. abscessus pulmonary disease are limited, especially in outpatient settings. Among parenteral antibiotics against M. abscessus, intravenous amikacin (AMK) is expected to be an effective outpatient antimicrobial therapy. This study evaluated the clinical efficacy and safety of intravenous AMK therapy in outpatients with M. abscessus pulmonary disease.
This retrospective chart review of cases of M. abscessus pulmonary disease evaluated patient background data, AMK dosage and duration, sputum conversion, clinical symptoms radiological findings, and adverse events. M. massiliense was excluded on the basis of multiplex PCR assay.
Thirteen patients (2 men and 11 women) with M. abscessus pulmonary disease were enrolled at 2 hospitals. The median age at the initiation of intravenous AMK treatment was 65 years (range: 50-86 years). Patients received a median AMK dose of 12.5 mg/kg (range: 8.3-16.2 mg/kg) for a median duration of 4 months (range: 3-9 months). The addition of intravenous AMK led to sputum conversion in 10 of 13 patients, and 8 patients continued to have negative sputum status 1 year after treatment. Approximately half of the patients showed improvement on chest high-resolution computed tomography. There were no severe adverse events such as ototoxicity, vestibular toxicity, and renal toxicity.
Thrice weekly intravenous AMK administration in outpatient settings is effective and safe for patients with M. abscessus pulmonary disease