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
Note that, during the initial therapy, amikacin should be administered with cefoxitin up to two weeks or until the patient improves clinically.
Antibiotic Dosage
| Antibiotic | Dosage |
| Clarithromycin | 1,000 mg/day |
| Azithromycin | 250 mg/day |
| Amikacin |
Once a day regimen
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| Cefoxitin | High dose, up to 12 g/day, divided dose |
| Imipenem | 500 mg, 2-4 times/day |
Antibiotic Duration of Therapy
- Skin or soft tissue infection: At least 4 months
- Bone infection: 6 months
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
- ↑ 1.0 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.