Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease

Byung Woo Jhun, Seong Mi Moon, Su Young Kim, Hye Yun Park, Kyeongman Jeon, O. Jung Kwon, Hee Jae Huh, Chang Seok Ki, Nam Yong Lee, Myung Jin Chung, Kyung Soo Lee, Sung Jae Shin, Charles L. Daley, Won Jung Koh

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

Intermittent, three-times-weekly oral antibiotic therapy is recommended for the initial treatment of noncavitary nodular bronchiectatic (NB) Mycobacterium avium complex (MAC) lung disease. However, intermittent therapy is not recommended for patients who have been previously treated. We evaluated 53 patients with recurrent noncavitary NB MAC lung disease who underwent antibiotic treatment for ≥12 months with daily therapy (n = 26) or intermittent therapy (n = 27) between January 2008 and December 2015. Baseline characteristics were comparable between daily therapy and intermittent therapy groups. Sputum culture conversion rates did not differ between daily therapy (21/26, 81%) and intermittent therapy (22/27, 82%) groups. Compared to the etiologic organism at the time of previous treatment, recurrent MAC lung disease was caused by the same MAC species in 38 patients (72%) and by a different MAC species in 15 patients (28%). Genotype analysis in patients with sequenced paired isolates revealed that 86% (12/14) of cases with same species recurrence were due to reinfection with a new MAC genotype. In conclusion, most recurrent noncavitary NB MAC lung disease cases were caused by reinfection rather than relapse. Intermittent antibiotic therapy is a reasonable treatment strategy for recurrent noncavitary NB MAC lung disease.

Original languageEnglish
Article numbere01812-17
JournalAntimicrobial agents and chemotherapy
Volume62
Issue number2
DOIs
Publication statusPublished - 2018 Feb

Bibliographical note

Funding Information:
for her help in statistical analysis. Dr. Charles L. Daley has received grants from Insmed Inc.

Funding Information:
This research was supported by theBasic Science Research Programthrough the National

Funding Information:
Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

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