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Jo, Park, Hong, Oh, Lee, Kim, Kim, Kim, and Shim: Long-term Outcome of Treatment of Mycobacterium Abscessus Pulmonary Disease
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2007; 62(2): 98-104.

Published online: 28 February 2007

DOI: https://doi.org/10.4046/trd.2007.62.2.98

Long-term Outcome of Treatment of Mycobacterium Abscessus Pulmonary Disease

Kyung Uk Jo, M.D, Soo Jung Park, M.D, Seok Chan Hong, M.D, Yeon-Mok Oh, M.D, Sang Do Lee, M.D, Woo Sung Kim, M.D, Dong Soon Kim, M.D, Won Dong Kim, M.D, Tae Sun Shim, M.D

Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.

Address for correspondence: Tae Sun Shim, MD. Address: Division of Pulmonary & Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, 388-1 Pungnap-Dong, Songpa-Ku, Seoul, 138-736, South Korea. Phone: 02-3010-3892, Fax: 02-3010-6968, shimts@amc.seoul.kr

Received 11 December 2006       Accepted 14 February 2007

Copyright © 2007 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Although there is an increasing incidence of Mycobacterium abscessus pulmonary disease in Korea, the optimal therapeutic regimen has not yet been established and there are no reports of the long-term treatment outcomes. This study examined the long-term treatment outcomes of M. abscessus pulmonary disease.

Methods

Twenty-nine patients diagnosed with M. abscessus pulmonary according to the American Thoracic Society criteria and treated from January 1996 to December 2003 were enrolled in ghis study. The clinical characteristics, radiological findings, treatment outcome, and follow up data were analyzed retrospectively.

Results

The mean age of the 29 patients was 56.1 (± 13.6) years and there was a female (22/29) dominance. The chest radiography revealed the nodular bronchiectatic type to be dominant (69%, 20/29). Twenty-seven (93.1%) were prescribed clarithromycin-containing regimens, and injectable drugs, mainly aminoglycosides, were included in the regimen of nineteen patients. The most predominant regimen (48.3%) consisted of clarithromycin and amikacin. The treatment success, failure, and default were achieved in 19(65.5%), 9(31.0%), and 1(3.4%), respectively. The median duration to culture conversion was 42 days (range 15-362) and the median duration of treatment in the success group was 543 days (range 176-1,160). An adjunctive surgical resection was performed in five patients, which resulted in treatment success in two patients. After the completion of treatment, nineteen patients were followed up for a median duration of 931 days (range 230-2,294). Only one (5.3%) patient relapsed 45 days after completing treatment.

Conclusion

Treatment with clarithromycin-containing regimens resulted in a successful treatment in approximately two thirds of patients with M. abscessus pulmonary disease. The long-term relapse rate was also quite low.

Keywords: Mycobacterium abscessus pulmonary disease, Treatment outcome, Long term result

Figures and Tables

Table 1
Baseline clinical characteristics and treatment ouctomes of 29 patients
trd-62-98-i001

*P>0.05 in all variables between groups

TB = Tuberculosis.

Table 2
The treatment regimen
trd-62-98-i002

*oral drug: rifampicin and/or ciprofloxacin

#other regimen: ofloxacin, prothionamide and kanamycin

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