Relationship between clinical efficacy for pulmonary MAC and drug-sensitivity test for isolated MAC in a recent 6-year period

https://doi.org/10.1007/s10156-011-0351-xGet rights and content

Abstract

There are a few recent reports about the relationship between the clinical effect and drug-sensitivity test. We investigated the relationship between the clinical efficacy of treatment for pulmonary Mycobacterium avium complex (MAC) and drug-sensitivity test for isolated MAC by comparison between data from 2005 to 2007 and from 2008 to 2010. We studied 60 patients who satisfied diagnostic criteria of nontuberculous mycobacterial infection established by the American Thoracic Society in 2007 and who received combination therapy using rifampicin (RFP), ethambutol (EB), streptomycin (SM), and clarithromycin (CAM). Average CAM dosage was increased from the early (517 mg/day) to the later (800 mg/day) period. Sputum conversion rate increased from 63% in the early period to 83% in the later period. Clinical improvement also increased from 38% in the early period to 53% in the later period. The causative microorganisms isolated were M. avium in 35 patients and M. intracellulare in 25. In both periods, isolated MAC strains showed excellent minimum inhibitory concentration (MIC) for CAM. Regarding the relationship between clinical efficacy and MICs of RFP, EB, CAM, and SM, most patients with good clinical effects showed low MIC for CAM in both periods. Good clinical efficacy, including the sputum conversion rate, was obtained with an increased dose of CAM in the later period. We speculate that the increased dose of CAM influenced the good clinical effect in both periods.

References (13)

There are more references available in the full text version of this article.

Cited by (39)

  • Microbiologic Outcome of Interventions Against Mycobacterium avium Complex Pulmonary Disease: A Systematic Review

    2018, Chest
    Citation Excerpt :

    In the study by Kobashi and Matsushima,39 the minimal inhibitory concentration was measured in only 48 of 65 patients, of whom three were Clari resistant. In only nine of 45 studies22,36-40,42,54,57 were subspecies of MAC (M intracellulare and/or M avium) determined to be present. Subspecies M chimaera was not identified in any of these therapeutic studies.

  • The clinical efficacy of a clarithromycin-based regimen for Mycobacterium avium complex disease: A nationwide post-marketing study

    2017, Journal of Infection and Chemotherapy
    Citation Excerpt :

    We conducted this survey in accordance with the ministerial ordinance on GPSP regarding data handling, self-monitoring, payment or receipt of money, and release of information. Although the ATS/IDSA statement recommend the option of an intermittent, thrice-weekly regimen for patients with nodular bronchiectatic-type disease, a CAM-based daily regimen has been recommended in Japan [15–18]. Thus, a CAM-based daily regimen was selected for the patients enrolled in this study, since some patients might have fibrocavitary-type disease.

View all citing articles on Scopus
View full text