Mycobacterium abscessus medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
The treatment of mycobacterium abscessus (M. abscessus) skin and soft tissue infection includes draining collections of pus, surgical debridement, and administration of combination of antibiotics. M. abscessus has variable in vitro drug susceptibilities profile; therefore, antibiotic susceptibility testing is required. M. abscessus infection is treated by a macrolide based multidrug antibiotic regimen. | |||
==Medical Therapy== | ==Medical Therapy== | ||
Revision as of 20:13, 23 July 2014
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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
The treatment of mycobacterium abscessus (M. abscessus) skin and soft tissue infection includes draining collections of pus, surgical debridement, and administration of combination of antibiotics. M. abscessus has variable in vitro drug susceptibilities profile; therefore, antibiotic susceptibility testing is required. M. abscessus infection is treated by a macrolide based multidrug antibiotic regimen.
Medical Therapy
Skin and Soft Tissue Infections
The treatment of mycobacterium abscessus includes 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:[1]
PLUS
Note that, during the initial therapy, amikacin should be administered with cefoxitin up to two weeks or until the patient improves clinically.[1]
Antibiotic Dosage
| Antibiotic | Dosage |
| Clarithromycin | 1,000 mg/day[1] |
| Azithromycin | 250 mg/day[1] |
| Amikacin |
Once a day regimen
|
| Cefoxitin | High dose, up to 12 g/day, divided dose[1] |
| Imipenem | 500 mg, 2-4 times/day[1] |
Antibiotic Duration of Therapy
- Skin or soft tissue infection: At least 4 months[1]
- Bone infection: 6 months[1]
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
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 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.