Association Between Duration of Aminoglycoside Treatment and Outcome of Cavitary Mycobacterium avium Complex Lung Disease.
| Autor: | Kim, Ock-Hwa, Kwon, Byoung Soo, Han, Minkyu, 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-Min, Huh, Jin-Won, Hong, Sang-Bum, Shim, Tae Sun, Jo, Kyung-Wook |
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| Předmět: |
LUNG disease diagnosis
MYCOBACTERIAL disease diagnosis AMINOGLYCOSIDES CONFIDENCE intervals HEALTH facilities LUNG diseases MEDICAL records MULTIVARIATE analysis MYCOBACTERIAL diseases PHYSICIANS DISEASE relapse TREATMENT effectiveness RETROSPECTIVE studies TREATMENT duration ODDS ratio THERAPEUTICS |
| Zdroj: | Clinical Infectious Diseases; Jun2019, Vol. 68 Issue 11, p1870-1876, 7p |
| Abstrakt: | Background Although aminoglycosides are recommended for cavitary Mycobacterium avium complex lung disease (MAC-LD), the optimal duration of treatment is unclear. We investigated the association between duration of aminoglycoside treatment and outcomes in cavitary MAC-LD. Methods Among patients diagnosed with macrolide-susceptible cavitary MAC-LD between 2000 and 2013, 101 who received treatment up to August 2017 with a regimen containing aminoglycosides were enrolled at a tertiary referral center in South Korea. Their medical records were retrospectively reviewed. The duration of aminoglycoside treatment was at the discretion of the attending physician. Results A total of 75 patients (74.3%) were administered aminoglycosides for ≥3 months (median 164 days), whereas the remaining 26 patients (25.7%) received treatment for <3 months (median 59 days). The overall treatment success rate was 63.4% (64/101). Patients treated with aminoglycosides for ≥3 months had a significantly higher success rate than those treated for <3 months (69.3% vs 46.2%; P =.035). Multivariate analysis revealed that aminoglycoside treatment for ≥3 months was a significant factor for treatment success (adjusted odds ratio, 3.602; 95% confidence interval, 1.249–10.390; P =.018). Recurrence occurred in 8 (22.9%) of 35 patients who were followed up for at least 3 years after the end of treatment; all 8 patients received aminoglycosides for ≥3 months. Conclusions Patients with cavitary MAC-LD treated with aminoglycosides for ≥3 months showed higher treatment success rate than those treated for <3 months. However, treatment for ≥3 months was not associated with the development of recurrence. [ABSTRACT FROM AUTHOR] |
| Databáze: | Complementary Index |
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