title: Induction therapy with linezolid/clarithromycin combination for Mycobacterium chelonae skin infections in immunocompromised hosts.
abstract: BACKGROUND
  The optimal management of Mycobacterium chelonae disease in immunocompromised patients remains unclear. A combination of antimicrobial agents is recommended as monotherapy with clarithromycin has been associated with clinical failures due to acquired resistance.
  
  
  OBJECTIVE
  We aim to report the efficacy and tolerability of linezolid in association with clarithromycin for the treatment of M. chelonae infections in immunocompromised patients.
  
  
  METHODS
  We describe four immunocompromised patients treated by linezolid and clarithromycin for cutaneous M. chelonae disease.
  
  
  RESULTS
  This combination was associated with rapid clinical efficacy in all patients with no relapse observed after a median follow-up of 2.25 years (1.4 years). However, this treatment was responsible for frequent adverse events including thrombocytopaenia, myalgia and mitochondrial toxicity. All adverse effects were reversible after linezolid discontinuation.
  
  
  CONCLUSIONS
  We therefore suggest linezolid/clarithromycin combination as the initial therapeutic strategy for M. chelonae skin infections in immunocompromised patients.
authors: Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors: P
authors: P
authors: Parize
authors: Service de Dermatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors: A
authors: A
authors: Hamelin
authors: UPMC Univ Paris 06, CR7, Centre d'Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology), Sorbonne Universités, Paris, France.|Centre d'Immunologie et des Maladies Infectieuses, CIMI, team E13 (Bacteriology), INSERM, U1135, Paris, France.|Centre National de Référence des Mycobactéries et de la Résistance des Mycobactéries aux Antituberculeux, Bactériologie-Hygiène, AP-HP, Hôpital Pitié-Salpêtrière, Paris, France.
authors: N
authors: N
authors: Veziris
authors: Service de Bactériologie, Hôpital Cochin Assistance, Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors: P C
authors: PC
authors: Morand
authors: Réanimation Chirurgicale Cardiovasculaire, Hôpital Européen Georges Pompidou, Université Paris Descartes, Paris, France.
authors: R
authors: R
authors: Guillemain
authors: Service de Maladies Infectieuses et Tropicales, Centre d'Infectiologie Necker-Pasteur, IHU Imagine, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors: O
authors: O
authors: Lortholary
authors: Service de Dermatologie, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Université Paris Descartes, Paris, France.
authors: N
authors: N
authors: Dupin
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000008:administration & dosage / Q000627:therapeutic use*; D004338:Drug Combinations; D005260:Female; D005602:France; D006801:Humans; D016867:Immunocompromised Host; D000069349:Linezolid / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000188:drug therapy*; D016926:Mycobacterium chelonae / Q000187:drug effects*; D012189:Retrospective Studies; D017192:Skin Diseases, Bacterial / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D004338:Drug Combinations; D017291:Clarithromycin; D000069349:Linezolid