<i>In Vitro</i>
            MIC Values of Rifampin and Ethambutol and Treatment Outcome in Mycobacterium avium Complex Lung Disease

Kwon, Byoung Soo; Kim, Seung Up; Sung, Heungsup; Koh, Younsuck; Kim, Woo Sung; Song, Jin Woo; Oh, Yeon Mok; Lee, Sang Do; Lee, Sei Won; Lee, Jae Seung; Lim, Chae Man; Choi, Chang; Huh, Jin Won; Hong, Sang Bum; Park, Sojung; Shim, Tae Sun; Chong, Yong Pil; Jo, Kyung‐Wook

doi:10.1128/aac.00491-18

Cited by 29 publications

(19 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In our study, clarithromycin showed good inhibitory activity against all MAC isolates, consistent with previous studies [19,20]. The resistance rate of MAC isolates against rifampin was 82.9% (92/111), which was in agreement (78.9%; 216/274) with a previous study [21]. Unlike rifampin, rifabutin showed a better antimicrobial activity and was recommended as an alternative to rifampicin, especially for disseminated MAC infections, for patients infected with MAC [22].…”

Section: Discussionsupporting

confidence: 91%

In Vitro Assessment of 17 Antimicrobial Agents Against Clinical Mycobacterium Avium Complex Isolates

Lin

Hua

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

Background: Recently, Mycobacterium avium complex (MAC) infections have been increasing, especially in immunocompromised and older adults. The rapid increase has triggered a global health concern due to limited therapeutic strategies and adverse effects caused by long-term medication. To provide more evidence for the treatment of MAC, we studied the in vitro inhibitory activities of 17 antimicrobial agents against clinical MAC isolates.Results: A total of 111 clinical MAC isolates were enrolled in the study and they were identified as M. intracellulare, M. avium, M. marseillense, M. colombiense, M. yongonense, M. arosience, and one isolate was undifferentiated at subspecies level. MAC strains had relatively low (0–21.6%) resistance to clarithromycin, amikacin, bedaquiline, rifabutin, streptomycin, and clofazimine, and the resistant rates to isoniazid, rifampin, linezolid, doxycycline, and ethionamide were very high (72.1–100%). In addition, M. avium and M. intracellulare had different resistance profiles for clarithromycin, ethambutol, trimethoprim/sulfamethoxazole, amikacin, linezolid, clofazimine, cycloserine, and ethionamide. Conclusions: Our results supported the current usage of macrolides, rifabutin, and aminoglycosides in the regimens for MAC infection, and also demonstrated the low resistance rate against new drugs, such as clofazimine, tedizolid, and bedaquiline, suggesting the possible implementation of these drugs in MAC treatment.

show abstract

Section: Discussionsupporting

confidence: 91%

In Vitro Assessment of 17 Antimicrobial Agents Against Clinical Mycobacterium Avium Complex Isolates

Lin

Hua

Wang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…In the management of MAC-LD, the clinical utility of drug susceptibility tests has not been established except for CLR [27]. Recently, an MIC ≥8 μg/mL for both EMB and RIF reflected an unfavorable response to standard treatment for MAC-LD [28]; however, it was not associated with negative sputum conversion in our patients with refractory MAC-LD. With regard to fluoroquinolone, MXF susceptibility break points, defined only by the Clinical and Laboratory Standards Institute, were not predictors of treatment response for refractory MAC-LD [15].…”

Section: Discussionmentioning

confidence: 91%

Sitafloxacin-Containing Regimen for the Treatment of Refractory Mycobacterium avium Complex Lung Disease

Asakura

Suzuki

Fukano

et al. 2019

Open Forum Infectious Diseases

View full text Add to dashboard Cite

Background Sitafloxacin (STFX) exhibits potent activity against Mycobacterium avium complex (MAC) in both in vitro and in vivo experiments. However, limited data are available for the clinical efficacy and adverse effects of STFX and the susceptibility of refractory MAC lung disease (MAC-LD) to the drug. Therefore, this study was aimed at evaluating the clinical efficacy and safety of an STFX-containing regimen for the treatment of refractory MAC-LD. Methods We retrospectively evaluated treatment outcomes of 31 patients with refractory MAC-LD, who received an STFX-containing regimen for ≥4 weeks between January 2010 and July 2017. Refractory MAC-LD was defined as persistent positive sputum cultures for >6 months of macrolide-based standard therapy. Results Clarithromycin resistance (minimum inhibitory concentration [MIC] ≥32 μg/mL) was identified in 15 patients (48%). Twelve months after receiving the STFX-containing regimen, 26% and 19% of patients showed symptomatic and radiological responses, respectively. Although STFX-associated adverse effects were noted in 9 patients, their severity was grade 1 (National Cancer Institute Common Terminology Criteria); only 1 patient discontinued STFX because of suspected gastrointestinal disturbance. Negative sputum culture conversion was achieved in 7 patients (23%). Both univariate and multivariate logistic regression analyses revealed that surgery, low STFX MIC (≤1 μg/mL), and macrolide resistance were significant predictors of negative sputum culture conversion. Conclusions Our results demonstrate that STFX may be effective in one-fourth of patients with refractory MAC-LD. Prospective larger studies that include the analyses of MAC are needed to determine the clinical efficacy of STFX against refractory MAC-LD.

show abstract

“…It must be mentioned that for rifabutin and rifampin, the concentration range tested in broth does not cover the entire MIC distribution, either because concentrations are too high (rifabutin) or too low (rifampin) (Figure 1). However, despite overall high in vitro MICs, it has been shown that rifamycins and ethambutol do prevent selection of clarithromycin resistance (May et al, 1997;Gordin et al, 1999;Benson et al, 2003), and a recent study reported a better clinical response when rifampin and/or ethambutol MICs were below 8 mg/L (Kwon et al, 2018). If these results are confirmed, this concentration could be used as a clinical breakpoint.…”

Section: Discussionmentioning

confidence: 99%

Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing

et al. 2020

View full text Add to dashboard Cite

The Clinical and Laboratory Standards Institute recommends the use of Mueller Hinton (MH) medium to perform drug susceptibility testing (DST) of Mycobacterium avium complex (MAC) using the microdilution method. For MAC, there has been no study on the impact of media on the determination of minimum inhibitory concentrations (MICs) of antibiotics other than clarithromycin. This study aimed at determining the impact of two media used for DST of MAC and at augmenting the number of pertinent MICs for MAC species encountered in clinical practice. MICs of antibiotics used for the treatment of MAC infections were determined for 158 clinical MAC isolates (80 M. avium, 40 M. intracellulare, 35 M. chimaera, two M. yongonense and one M. timonense) in MH and 7H9 broths using the SLOMYCO Sensititre TM system (TREK Diagnostic Systems, East Grinstead, United Kingdom). The modal MICs determined in both media were the same for linezolid, moxifloxacin, rifabutin and amikacin but not for clarithromycin, rifampin and ethambutol. The kappa test for MICs converted to susceptibility categories showed an excellent agreement for clarithromycin, a moderate agreement for linezolid and a weak agreement for moxifloxacin and amikacin. For amikacin, 7H9 allowed a better distinction (fewer intermediate strains) of wild-type populations than MH. Existing breakpoints for linezolid and moxifloxacin are spread through the distribution of MICs for wild-type populations. The only breakpoints that can be used rationally are those for amikacin and clarithromycin. For amikacin, 7H9 performs better than MH, whereas both media perform equally for clarithromycin. Given that testing in 7H9, as opposed to MH, allows easier MIC measurements and yields greater reproducibility, we propose the use of 7H9 medium for DST of MAC.

show abstract

In Vitro MIC Values of Rifampin and Ethambutol and Treatment Outcome in Mycobacterium avium Complex Lung Disease

Cited by 29 publications

References 39 publications

In Vitro Assessment of 17 Antimicrobial Agents Against Clinical Mycobacterium Avium Complex Isolates

In Vitro Assessment of 17 Antimicrobial Agents Against Clinical Mycobacterium Avium Complex Isolates

Sitafloxacin-Containing Regimen for the Treatment of Refractory Mycobacterium avium Complex Lung Disease

Rational Choice of Antibiotics and Media for Mycobacterium avium Complex Drug Susceptibility Testing

Contact Info

Product

Resources

About