Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease

Abstract

Treatment of Mycobacterium abscessus pulmonary infection requires long-term administration of multiple antibiotics. Little is known, however, about the impact of each antibiotic on treatment outcomes. A retrospective analysis was conducted to evaluate the efficacy and adverse effects of antibiotics administered in 244 cases of M. abscessus pulmonary disease. Only 110 (45.1%) patients met the criteria for treatment success. Treatment with amikacin (AOR, 3.275; 95% CI, 1.221 - 8.788), imipenem (AOR, 2.078; 95% CI, 1.151 - 3.753), linezolid (AOR, 2.231; 95% CI, 1.078 - 4.616) and tigecycline (AOR, 2.040; 95% CI, 1.079 - 3.857) was successful. The incidence of adverse effects was high (192/244, 78.7%). Severe adverse effects were primarily: ototoxicity (14/60, 23.3%) caused by amikacin; gastrointestinal (14/60, 23.3%) caused by tigecycline; and myelosuppression (5/60, 8.3%) caused by linezolid. In conclusion, the rate of success in treating M. abscessus pulmonary disease is still unsatisfactory; the administration of amikacin, imipenem, linezolid and tigecycline correlated with increased treatment success. Adverse side effects are common due to the long-term and combined antibiotic therapy. Ototoxicity, gastrointestinal and myelosuppression are the most severe.