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Analysis of drug treatment outcome in clarithromycin-resistant Mycobacterium avium complex lung disease

Overview of attention for article published in BMC Infectious Diseases, January 2016
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Title
Analysis of drug treatment outcome in clarithromycin-resistant Mycobacterium avium complex lung disease
Published in
BMC Infectious Diseases, January 2016
DOI 10.1186/s12879-016-1384-7
Pubmed ID
Authors

Tsukasa Kadota, Hirotoshi Matsui, Takashi Hirose, Junko Suzuki, Minako Saito, Tomohiro Akaba, Kouichi Kobayashi, Shunsuke Akashi, Masahiro Kawashima, Atsuhisa Tamura, Hideaki Nagai, Shinobu Akagawa, Nobuyuki Kobayashi, Ken Ohta

Abstract

Although the isolation of clarithromycin (CAM)-resistant Mycobacterium avium complex (MAC) indicates a poor treatment outcome and increased mortality, there have been only a few reports on drug treatment for CAM-resistant MAC lung disease. We aimed to reveal the effectiveness of the continuation of a macrolide and the use of a multidrug regimen in the treatment of CAM-resistant MAC lung disease. Among patients with MAC pulmonary disease as defined by the 2007 criteria of the American Thoracic Society and the Infectious Diseases Society of America statement, those with CAM-resistant MAC (minimum inhibitory concentration ≥32 μg/ml) isolated, newly diagnosed and treated from January 2009 to June 2013 were analysed in this study. Effectiveness was measured based on culture conversion rate and improvement of radiological findings. Thirty-three HIV-negative patients were analysed in this study. Twenty-six were treated with a regimen containing CAM or azithromycin (AZM), and 21 patients were treated with three or more drugs except macrolide. The median duration to be evaluated was 10.4 months after beginning the treatment regimen. Sputum conversion (including cases of inability to expectorate sputum) was achieved in 12 (36 %) patients. Radiological effectiveness improved in 4 (12 %) patients, was unchanged in 11 (33 %) patients and worsened in 18 (55 %) patients. In the multivariate analysis, CRP <1.0 mg/dl (p = 0.017, odds ratio 12, 95 % confidence interval (CI) 1.6-95) was found to be the only significant risk factor for radiological non-deterioration, and no significant risk factors for microbiological improvement were found. Our results suggested that continuation of macrolides or the addition of a new quinolone or injectable aminoglycoside to therapy with rifampicin and ethambutol would not improve clinical outcome after the emergence of CAM-resistant MAC. However, further prospective study is required to evaluate the precise clinical efficacy and effectiveness of these drugs.

Twitter Demographics

The data shown below were collected from the profiles of 2 tweeters who shared this research output. Click here to find out more about how the information was compiled.

Mendeley readers

The data shown below were compiled from readership statistics for 53 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Japan 1 2%
India 1 2%
Unknown 51 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 12 23%
Student > Master 7 13%
Student > Bachelor 4 8%
Professor 4 8%
Student > Doctoral Student 4 8%
Other 15 28%
Unknown 7 13%
Readers by discipline Count As %
Medicine and Dentistry 27 51%
Immunology and Microbiology 4 8%
Agricultural and Biological Sciences 4 8%
Veterinary Science and Veterinary Medicine 3 6%
Biochemistry, Genetics and Molecular Biology 2 4%
Other 3 6%
Unknown 10 19%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 20 August 2016.
All research outputs
#9,722,652
of 12,160,231 outputs
Outputs from BMC Infectious Diseases
#3,186
of 4,474 outputs
Outputs of similar age
#240,145
of 346,784 outputs
Outputs of similar age from BMC Infectious Diseases
#78
of 100 outputs
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