Royal Perth Hospital, Perth, Western Australia, Australia.
PathWest Laboratory Medicine, Perth, Western Australia, Australia.
Intern Med J. 2023 Dec;53(12):2257-2263. doi: 10.1111/imj.16071. Epub 2023 Mar 25.
Antimicrobial resistance and therapy-related adverse effects make Mycobacterium abscessus treatment challenging. Omadacycline is a novel, bioavailable aminomethylcycline with favourable in vitro activity against M. abscessus.
To describe a case report and review the published literature describing outcomes for M. abscessus infections treated with omadacycline.
Systematic literature review.
We identified three articles that, in addition to our case report, describe 18 patients. Pulmonary infections were most frequent. Minimum inhibitory concentrations were reported for two isolates (0.25 and 0.5 mg/L). Despite half the patients starting omadacycline because of failure of prior therapy, 15 (83%) had a favourable outcome, defined as 'cure', 'improvement' or 'clinical success' as determined by the primary study authors. One patient (6%) discontinued omadacycline because of gastrointestinal intolerance.
Although the limited observational data and in vitro susceptibility results are encouraging, randomised control trials are required to determine the role of omadacycline as part of combination therapy for this most difficult-to-treat pathogen.
由于抗菌药物耐药性和治疗相关的不良反应，导致脓肿分枝杆菌的治疗具有挑战性。 奥马环素是一种新型、可生物利用的氨甲基环素，对脓肿分枝杆菌具有良好的体外活性。
描述 1 例病例报告，并复习已发表的文献，以评估奥马环素治疗脓肿分枝杆菌感染的结果。
系统文献复习。
我们共确定了 3 篇文章，除了我们的病例报告外，还描述了 18 例患者。肺部感染最为常见。有 2 个分离株（0.25 和 0.5mg/L）报告了最低抑菌浓度。尽管有一半的患者因先前治疗失败而开始使用奥马环素，但 15 例（83%）的结局良好，根据主要研究作者的定义为“治愈”、“改善”或“临床成功”。1 例（6%）患者因胃肠道不耐受而停用奥马环素。
尽管观察性数据有限且体外药敏结果令人鼓舞，但仍需要随机对照试验来确定奥马环素作为这种最难治疗病原体的联合治疗的一部分的作用。
