Division of Pulmonary and Critical Care Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea.
Department of Internal Medicine, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, South Korea.
J Infect Chemother. 2014 Oct;20(10):602-6. doi: 10.1016/j.jiac.2014.05.010. Epub 2014 Jun 26.
We aimed to investigate the treatment outcomes of patients with refractory Mycobacterium avium complex (MAC) lung disease treated with regimens containing drugs with unclear efficacy. Of all patients diagnosed with MAC lung disease between April 2004 and September 2012 at a tertiary referral center in South Korea, the outcomes of 51 patients treated with regimens containing drugs with unclear efficacy (clofazimine, moxifloxacin, rifabutin, and linezolid) because of treatment failure after receiving standard treatment were retrospectively analyzed. The mean age (standard deviation) of the 51 patients was 59.0 (10.3) years and 29 (56.9%) were male. The etiologic agent was M. avium in 17 patients (33.3%) and Mycobacterium intracellulare in 34 patients (66.7%); 42 patients (82.4%) had the fibrocavitary form of the disease. Of the 51 patients, 26, 28, 35, and 7 received clofazimine-, moxifloxacin-, rifabutin-, and linezolid-containing regimens (numbers are not mutually exclusive), with median drug administration durations of 147, 128, 209, and 88 days, respectively. Overall, 8 patients (15.7%) had a favorable response. Treatment outcomes did not differ by drug regimen or even by the combination of more than 2 drugs. The treatment outcomes of patients with refractory MAC lung disease were unsatisfactory with regimens containing possibly effective drugs such as clofazimine, moxifloxacin, rifabutin and linezolid.
我们旨在研究含疗效不明确药物方案治疗耐多药鸟分枝杆菌复合群（MAC）肺病患者的治疗结局。在韩国一家三级转诊中心，2004 年 4 月至 2012 年 9 月期间所有被诊断为 MAC 肺病的患者中，回顾性分析了 51 例因标准治疗后治疗失败而接受含疗效不明确药物（氯法齐明、莫西沙星、利福布汀和利奈唑胺）方案治疗的患者的结局。51 例患者的平均年龄（标准差）为 59.0（10.3）岁，29 例（56.9%）为男性。17 例（33.3%）的病原体为鸟分枝杆菌，34 例（66.7%）为胞内分枝杆菌；42 例（82.4%）为纤维空洞型。51 例患者中，26、28、35 和 7 例分别接受了含氯法齐明、莫西沙星、利福布汀和利奈唑胺的方案（数字不互斥），药物治疗的中位持续时间分别为 147、128、209 和 88 天。总体而言，8 例（15.7%）患者有良好的反应。治疗结局不因药物方案而不同，甚至联合使用 2 种以上药物也没有差异。含氯法齐明、莫西沙星、利福布汀和利奈唑胺等可能有效的药物的方案治疗耐多药 MAC 肺病患者的结局并不令人满意。
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