Mycobacterium abscessus medical therapy

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Rim Halaby, M.D. [2]

Overview

Medical Therapy

Skin and Soft Tissue Infections

The treatment of mycobacterium abscessus include the following:

  • Draining collections of pus
  • Surgical debridement[1]
  • Administration of combination of antibiotics for a prolonged period of time: macrolide based regimen[1]

Antibiotic Regimen

In case of serious skin, soft tissues, and bones infection, a combination of antibiotics need to be administered:

PLUS

Antibiotic Dosage

Antibiotic Dosage
Clarithromycin 1,000 mg/day
Azithromycin 250 mg/day
Amikacin

Once a day regimen
- Adults <50 years and normal renal function: 10-15 mg/kg
- Age >50 years and/or anticipated long term therapy for more than 3 weeks: 10 mg/kg


Three times per week regimen
- 25 mg/kg

Cefoxitin High dose, up to 12 g/day, divided dose
Imipenem 500 mg, 2-4 times/day

Pulmonary Infection

  • Administration of combination of antibiotics for a prolonged period of time: clarithromycin 1,000 mg/day based regimen[1]
    • A combination of antibiotics is indicated for the treatment of pulmonary infection with mycobacterium abscessus; however, there is no evidence on the optimal multidrug regimen.
  • Surgical resection of the localized disease[1]
    • Surgical resection and multidrug antibiotic therapy is associated with a higher chance of a successful treatment.

References

  1. 1.0 1.1 1.2 1.3 Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F; et al. (2007). "An official ATS/IDSA statement: diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases". Am J Respir Crit Care Med. 175 (4): 367–416. doi:10.1164/rccm.200604-571ST. PMID 17277290.


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