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Inappropriate Treatment Fuels MR-MAC

November 10, 2016 at 2:17 pm

By John Hansen-Flaschen, MD, editor, Annals of the American Thoracic Society

Follow Dr. Hansen-Flaschen on Twitter @AnnalsATSEditor

Macrolide-Resistant Mycobacterium avium Complex Lung Infection: An Analysis of 102 Consecutive Cases

In a retrospective study of patients with macrolide-resistant Mycobacterium avium (MR-MAC) at three Japanese hospitals, researchers found that nearly 60 percent received inappropriate first-line treatment. The most common factor in deviating from standard therapy appeared to be the adverse effects of ethambutol, the authors report in their November Annals of the American Thoracic Society article. Other findings: the median time between treatment initiation and confirmation of macrolide resistance was 63 months, five-year survival of patients with MR-MAC was 71 percent (similar to those with multidrug-resistant TB), and combination treatment with aminoglycosides and surgery significantly improved prognosis. The authors concluded that “drug sensitivity testing must be aggressively performed to identify MR-MAC in the early stages….and new drugs for treating this refractory disease are needed.”

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