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, SungJae Shin, Charles L. Daley, Won Jung Koh

Research output: Contribution to journalArticle

4 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 1

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Mycobacterium avium Complex
Lung Diseases
Anti-Bacterial Agents
Therapeutics
Genotype
Recurrence
Group Psychotherapy
Sputum

All Science Journal Classification (ASJC) codes

  • Pharmacology
  • Pharmacology (medical)
  • Infectious Diseases

Cite this

Jhun, B. W., Moon, S. M., Kim, S. Y., Park, H. Y., Jeon, K., Jung Kwon, O., ... Koh, W. J. (2018). Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease. Antimicrobial Agents and Chemotherapy, 62(2), [e01812-17]. https://doi.org/10.1128/AAC.01812-17
Jhun, Byung Woo ; Moon, Seong Mi ; Kim, Su Young ; Park, Hye Yun ; Jeon, Kyeongman ; Jung Kwon, O. ; Huh, Hee Jae ; Ki, Chang Seok ; Lee, Nam Yong ; Chung, Myung Jin ; Lee, Kyung Soo ; Shin, SungJae ; Daley, Charles L. ; Koh, Won Jung. / Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease. In: Antimicrobial Agents and Chemotherapy. 2018 ; Vol. 62, No. 2.
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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.",
author = "Jhun, {Byung Woo} and Moon, {Seong Mi} and Kim, {Su Young} and Park, {Hye Yun} and Kyeongman Jeon and {Jung Kwon}, O. and Huh, {Hee Jae} and Ki, {Chang Seok} and Lee, {Nam Yong} and Chung, {Myung Jin} and Lee, {Kyung Soo} and SungJae Shin and Daley, {Charles L.} and Koh, {Won Jung}",
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Jhun, BW, Moon, SM, Kim, SY, Park, HY, Jeon, K, Jung Kwon, O, Huh, HJ, Ki, CS, Lee, NY, Chung, MJ, Lee, KS, Shin, S, Daley, CL & Koh, WJ 2018, 'Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease', Antimicrobial Agents and Chemotherapy, vol. 62, no. 2, e01812-17. https://doi.org/10.1128/AAC.01812-17

Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease. / Jhun, Byung Woo; Moon, Seong Mi; Kim, Su Young; Park, Hye Yun; Jeon, Kyeongman; Jung Kwon, O.; Huh, Hee Jae; Ki, Chang Seok; Lee, Nam Yong; Chung, Myung Jin; Lee, Kyung Soo; Shin, SungJae; Daley, Charles L.; Koh, Won Jung.

In: Antimicrobial Agents and Chemotherapy, Vol. 62, No. 2, e01812-17, 01.02.2018.

Research output: Contribution to journalArticle

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T1 - Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease

AU - Jhun, Byung Woo

AU - Moon, Seong Mi

AU - Kim, Su Young

AU - Park, Hye Yun

AU - Jeon, Kyeongman

AU - Jung Kwon, O.

AU - Huh, Hee Jae

AU - Ki, Chang Seok

AU - Lee, Nam Yong

AU - Chung, Myung Jin

AU - Lee, Kyung Soo

AU - Shin, SungJae

AU - Daley, Charles L.

AU - Koh, Won Jung

PY - 2018/2/1

Y1 - 2018/2/1

N2 - 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.

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