Clofazimine (CFZ) is used to treat pulmonary non-tuberculous mycobacterial (NTM) infection; however, its pharmacokinetics remain unexplored in patients with pulmonary NTM, and the relationship between CFZ serum concentration and adverse effects has not been investigated. The objectives of this study were to characterize the pharmacokinetics of CFZ in pulmonary NTM disease treatment and to investigate the relationship between the steady-state CFZ serum concentration and adverse effects.
The MICs of isolates from 86 patients with
Mycobacterium abscessus
(MABS); 46 with
Mycobacterium abscessus
subsp.
abscessus
(Mab), and 40 with
Mycobacterium abscessus
subsp.
massiliense
(Mma) were retrospectively analyzed. The main findings are as follows: i) Mma were significantly more susceptible to clarithromycin and azithromycin than Mab, and both subspecies tended to be more susceptible to clarithromycin than azithromycin. ii) Most isolates were susceptible to amikacin (93.0%), and over half to linezolid (55.8%). iii) Fifty-one isolates (59.3%) had MIC values of less than 1 μg/mL for sitafloxacin, and 65 (75.6%) had less than 0.5 μg/mL for clofazimine, which seems worth clinical investigating. iv) Among nine cases analyzed chronological changes, only two patients showed obvious MIC result changes even after the long-term multidrug treatment.
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