Efficacy and safety of tigecycline for Mycobacterium abscessus disease
Efficacy and safety of tigecycline for Mycobacterium abscessus disease
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DOI：
10.1016/j.rmed.2019.10.006
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发表时间：
2019-10-01
影响因子：
4.3
通讯作者：
Daley, Charles L.
中科院分区：
文献类型：
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作者：
Kwon, Yong-Soo;Levin, Adrah;Daley, Charles L.
目的：结核分枝杆菌病是最难治愈的分枝杆菌感染之一，因为该细菌对常规抗生素具有高度耐药性。本研究的目的是评价替加环素治疗M的疗效和安全性。方法：我们对M。2009年1月至2017年12月在National Jewish Health接受含替格列汀方案治疗的肺结核患者。膀胱疾病（n = 29，82.9%）。在接受替加环素治疗的患者中，17.4%（4/23）显示微生物改善（≥ 2次连续阴性痰培养），而86.2%（25/29）和59.3%（16/27）分别显示症状和放射学改善。在中位56.5天（IQR 10.8-122.3）时，由于药物不良反应导致替加环素剂量减少或停药的发生率为57.1%（20/35）。最常见的药物不良反应是胃肠道副作用，包括恶心、呕吐和腹泻。骨关节炎有很高的症状和放射学改善率。然而，考虑到不良的微生物学反应和常见的不良反应，替加环素治疗的患者的选择和药物不良反应的监测应谨慎进行。
Purpose: Mycobacterium abscessus disease is one of the most difficult mycobacterial infections to cure, as the bacterium is highly resistant to conventional antibiotics. The purpose of this study was to evaluate the efficacy and safety of tigecycline treatment of M. abscessus disease.Procedure: We performed retrospective chart reviews of patients with M. abscessus disease receiving tigecycline-containing regimens at National Jewish Health from January 2009 to December 2017.Main findings: Among the 35 patients, pulmonary disease was the most common presentation of M. abscessus disease (n = 29, 82.9%). Of those receiving tigecycline treatment, 17.4% (4/23) showed microbiological improvement (>= 2 consecutive negative sputum cultures), while 86.2% (25/29) and 59.3% (16/27) showed symptomatic and radiological improvements, respectively. The rate of dose reduction or discontinuation of tigecycline owing to adverse drug reactions was 57.1% (20/35) at a median of 56.5 days (IQR 10.8-122.3). The most common adverse drug reactions were gastrointestinal side effects, including nausea, vomiting, and diarrhea.Conclusions: Tigecycline-containing regimens for M. abscessus disease have a high rate of symptomatic and radiological improvement. However, considering the poor microbiological response and the common adverse effects, selection of patients for tigecycline treatment and monitoring for adverse drug reactions should be performed carefully.