Failure of the Amikacin, Cefoxitin, and Clarithromycin Combination Regimen for Treating Pulmonary Mycobacterium abscessus Infection

Antimicrob Agents Chemother. 2016 Sep 23;60(10):6374-6. doi: 10.1128/AAC.00990-16. Print 2016 Oct.

Abstract

In a hollow-fiber model, we mimicked the drug exposures achieved in the lungs of humans treated with standard amikacin, clarithromycin, and cefoxitin combination therapy for Mycobacterium abscessus infection. At optimal dosing, a kill rate of -0.09 (95% confidence interval, -0.04 to 0.03) log10 CFU per ml/day was achieved over the first 14 days, after which there was regrowth due to acquired drug resistance. Thus, the standard regimen quickly failed. A new regimen is needed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Amikacin / pharmacology*
  • Anti-Bacterial Agents / pharmacology
  • Cefoxitin / pharmacology*
  • Clarithromycin / pharmacology*
  • Drug Therapy, Combination
  • Humans
  • Microbial Sensitivity Tests
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Nontuberculous Mycobacteria / growth & development
  • Nontuberculous Mycobacteria / pathogenicity*
  • Treatment Failure

Substances

  • Anti-Bacterial Agents
  • Cefoxitin
  • Amikacin
  • Clarithromycin