Failure of the Amikacin, Cefoxitin, and Clarithromycin Combination Regimen for Treating Pulmonary Mycobacterium abscessus Infection.

Abstract

In a hollow-fiber model, we mimicked the drug exposures achieved in the lungs of humans treated with standard amikacin, clarithromycin, and cefoxitin combination therapy for Mycobacterium abscessus infection. At optimal dosing, a kill rate of -0.09 (95% confidence interval, -0.04 to 0.03) log10 CFU per ml/day was achieved over the first 14 days, after which there was regrowth due to acquired drug resistance. Thus, the standard regimen quickly failed. A new regimen is needed.

• Authors: Beatriz E Ferro, Shashikant Srivastava, Devyani Deshpande, Jotam G Pasipanodya, Dick van Soolingen, Johan W Mouton, Jakko van Ingen, Tawanda Gumbo
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 60 Issue 10 Pg. 6374-6 (10 2016) ISSN: 1098-6596 [Electronic] United States
• PMID: 27458221 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Chemical References

• Anti-Bacterial Agents
• Cefoxitin
• Amikacin
• Clarithromycin

Topics

• Amikacin (pharmacology)
• Anti-Bacterial Agents (pharmacology)
• Cefoxitin (pharmacology)
• Clarithromycin (pharmacology)
• Drug Therapy, Combination
• Humans
• Microbial Sensitivity Tests
• Mycobacterium Infections, Nontuberculous (drug therapy, microbiology)
• Nontuberculous Mycobacteria (growth & development, pathogenicity)
• Treatment Failure