Outcomes in patients with Mycobacterium abscessus pulmonary disease treated with long-term injectable drugs

Respir Med. 2011 May;105(5):781-7. doi: 10.1016/j.rmed.2010.12.012. Epub 2011 Jan 5.


Background: The ATS (American Thoracic Society) has recommended periodic administration of multidrug therapy, including a macrolide and one or more parenteral agents or a combination of parenteral agents, over 2-4 months, for treatment of Mycobacterium abscessus pulmonary disease. However, there is little hard evidence supporting these guidelines, and treatment outcomes have not yet been reported.

Methods: We retrospectively evaluated 41 patients with M. abscessus pulmonary disease treated in accordance with ATS guidelines. These patients were treated empirically with multidrug regimens, including a macrolide and one (amikacin) or more (amikacin and cefoxitin or imipenem) parenteral agents, over several months. Treatment outcomes were defined as treatment success, failure, or default.

Results: Seventeen (41.5%) patients were prescribed a macrolide and one parenteral agent, and 24 (58.5%) were prescribed a macrolide and two parenteral agents. The median duration of parenteral and total antibiotic treatment were 230 days (range, 60-601 days) and 511 days (range, 164-1249 days), respectively. The treatment success, failure, and default rates were 80.5% (33/41), 12.2% (5/41), and 7.3% (3/41), respectively. Four patients relapsed over 445 days (range, 0-1443 days) of follow-up. There were no significant differences in treatment success and relapse rates between the groups receiving one and two parenteral agents. Adverse reactions developed in 18 of 41 patients (43.9%).

Conclusions: Combination antibiotic therapy, including long-term (minimum 2-4 months) parenteral drugs, as recommended by the ATS, resulted in successful treatment outcomes in 80.5% of patients with M. abscessus lung disease in Korea.

MeSH terms

  • Abscess / drug therapy*
  • Abscess / microbiology
  • Adult
  • Aged
  • Female
  • Humans
  • Lung Diseases / drug therapy*
  • Lung Diseases / microbiology
  • Macrolides / administration & dosage*
  • Male
  • Middle Aged
  • Mycobacterium Infections / drug therapy*
  • Mycobacterium Infections / microbiology
  • Practice Guidelines as Topic
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult


  • Macrolides