Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease
Clinical Efficacy and Adverse Effects of Antibiotics Used to Treat Mycobacterium abscessus Pulmonary Disease
复制标题
用于治疗脓肿分枝杆菌肺部疾病的抗生素的临床疗效和不良反应。
DOI：
10.3389/fmicb.2019.01977
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发表时间：
2019-08-23
影响因子：
5.2
通讯作者：
Chu, Haiqing
中科院分区：
文献类型：
--
作者：
Chen, Jianhui;Zhao, Lan;Chu, Haiqing
结核分枝杆菌肺部感染的治疗需要长期使用多种抗生素。然而，人们对每种抗生素对治疗结果的影响知之甚少。回顾性分析244例支原体感染的临床资料，评价抗生素治疗的疗效和不良反应。肺部疾病。仅110例（45.1%）患者符合治疗成功标准。治疗M.结核性肺病仍然不能令人满意，特别是涉及M.红腹叶蝉亚种你好联合药物治疗包括阿米卡星[校正比值比（AOR），3.275; 95%置信区间（CI），1.221-8.788]，亚胺培南（AOR，2.078; 95% CI，1.151-3.753）、利奈唑胺（AOR，2.231; 95% CI，1.078-4.616）或替加环素（AOR，2.040; 95% CI，1.079-3.857）是成功的。不良副作用影响了大多数患者（192/244，78.7%）。导致治疗调整的重度反应包括：主要由替加环素引起的胃肠道不适（29/60，48.3%）、阿米卡星引起的耳毒性（14/60，23.3%）和主要由利奈唑胺引起的骨髓抑制（6/60，10%）。结论：M.肺部疾病仍然不能令人满意。阿米卡星、亚胺培南、利奈唑胺和替加环素的给药与治疗成功率增加相关。由于长期联合抗生素治疗，不良副作用很常见。耳毒性、胃肠道不适和骨髓抑制是最严重的。
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. The efficacy of treating M. abscessus pulmonary disease continues to be unsatisfactory especially for infections involving M. abscessus subsp. abscessus. Treatment with drug combinations that included amikacin [adjusted odds ratio (AOR), 3.275; 95% confidence interval (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), or tigecycline (AOR, 2.040; 95% CI, 1.079-3.857) was successful. Adverse side effects affected the majority of patients (192/244, 78.7%). Severe effects that resulted in treatment modification included: gastrointestinal distress (29/60, 48.3%) mostly caused by tigecycline, ototoxicity (14/60, 23.3%) caused by amikacin; and myelosuppression (6/60, 10%) caused mainly by linezolid. In conclusion, the success rate of treatment of 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 long-term, combination antibiotic therapy. Ototoxicity, gastrointestinal distress, and myelosuppression are the most severe.