Treatment with a macrolide-containing regimen for Mycobacterium kansasii pulmonary disease.
Respir Med
; 148: 37-42, 2019 03.
Article
en En
| MEDLINE
| ID: mdl-30827472
ABSTRACT
BACKGROUND:
Mycobacterium kansasii is a major pathogen associated with nontuberculous mycobacterial pulmonary disease. For treatment of M. kansasii pulmonary disease, daily therapy with isoniazid, rifampin, and ethambutol is traditionally recommended. Although a regimen containing a macrolide, instead of isoniazid, has been recently recommended, supporting data are limited. We compared the treatment outcomes of a macrolide-containing regimen (macrolide group) and an isoniazid-containing regimen (isoniazid group) on patients with M. kansasii pulmonary disease.METHODS:
A total of 49 patients were identified between January 2002 and December 2016. Treatment outcomes for the isoniazid group (nâ¯=â¯24) and the macrolide group (nâ¯=â¯25) were compared.RESULTS:
Baseline characteristics of the isoniazid and macrolide groups were similar. Favorable outcomes did not differ between the isoniazid group (79%, nâ¯=â¯19) and macrolide group (88%, nâ¯=â¯22, Pâ¯=â¯0.463). Total treatment duration (median 17.9 months vs. 15.4 months; Pâ¯=â¯0.712) and time to culture conversion (median 2.0 months vs. 1.2 months; Pâ¯=â¯0.838) were also similar between the isoniazid and macrolide groups. Five patients who completed three-times-weekly intermittent treatment containing a macrolide for non-cavitary M. kansasii pulmonary disease achieved negative sputum culture conversion within 12 months of treatment. Only one patient experienced recurrence of M. kansasii pulmonary disease in the isoniazid group.CONCLUSIONS:
A macrolide-containing regimen appears to be as effective as an isoniazid-containing regimen for treatment of M. kansasii pulmonary disease. Additionally, intermittent therapy containing a macrolide could be an alternative treatment option for non-cavitary M. kansasii pulmonary disease.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
3_ND
Problema de salud:
3_neglected_diseases
/
3_tuberculosis
Asunto principal:
Macrólidos
/
Mycobacterium kansasii
/
Enfermedades Pulmonares
/
Infecciones por Mycobacterium no Tuberculosas
Tipo de estudio:
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
País/Región como asunto:
Asia
Idioma:
En
Revista:
Respir Med
Año:
2019
Tipo del documento:
Article
País de afiliación:
Corea del Sur