Parize P, Hamelin A, Veziris N, Morand P C, Guillemain R, Lortholary O, Dupin N
Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
Service de Dermatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
J Eur Acad Dermatol Venereol. 2016 Jan;30(1):101-5. doi: 10.1111/jdv.12965. Epub 2015 Feb 11.
The optimal management of Mycobacterium chelonae disease in immunocompromised patients remains unclear. A combination of antimicrobial agents is recommended as monotherapy with clarithromycin has been associated with clinical failures due to acquired resistance.
We aim to report the efficacy and tolerability of linezolid in association with clarithromycin for the treatment of M. chelonae infections in immunocompromised patients.
We describe four immunocompromised patients treated by linezolid and clarithromycin for cutaneous M. chelonae disease.
This combination was associated with rapid clinical efficacy in all patients with no relapse observed after a median follow-up of 2.25 years (1.4 years). However, this treatment was responsible for frequent adverse events including thrombocytopaenia, myalgia and mitochondrial toxicity. All adverse effects were reversible after linezolid discontinuation.
We therefore suggest linezolid/clarithromycin combination as the initial therapeutic strategy for M. chelonae skin infections in immunocompromised patients.
免疫功能低下患者中龟分枝杆菌病的最佳治疗方案仍不明确。由于获得性耐药，克拉霉素单药治疗与临床失败相关，因此推荐联合使用抗菌药物。
我们旨在报告利奈唑胺联合克拉霉素治疗免疫功能低下患者龟分枝杆菌感染的疗效和耐受性。
我们描述了4例接受利奈唑胺和克拉霉素治疗皮肤龟分枝杆菌病的免疫功能低下患者。
这种联合治疗在所有患者中均具有快速的临床疗效，中位随访2.25年（1.4年）后未观察到复发。然而，这种治疗导致频繁的不良事件，包括血小板减少、肌痛和线粒体毒性。停用利奈唑胺后，所有不良反应均可逆。
因此，我们建议利奈唑胺/克拉霉素联合治疗作为免疫功能低下患者龟分枝杆菌皮肤感染的初始治疗策略。
