title: Clofazimine-Containing Regimen for the Treatment of Mycobacterium abscessus Lung Disease.
abstract: Patients with lung disease caused byMycobacterium abscessussubsp.abscessus(hereM. abscessus) typically have poor treatment outcomes. Although clofazimine (CFZ) has been increasingly used in the treatment ofM. abscessuslung disease in clinical practice, there are no reported data on its effectiveness for this disease. This study sought to evaluate the clinical efficacy of a CFZ-containing regimen for the treatment ofM. abscessuslung disease. We performed a retrospective review of the medical records of 42 patients withM. abscessuslung disease who were treated with CFZ-containing regimens between November 2013 and January 2015. CFZ was administered in combination with other antibiotics as an initial antibiotic regimen in 15 (36%) patients (initial treatment group), and it was added to an existing antibiotic regimen for refractoryM. abscessuslung disease in 27 (64%) patients (salvage treatment group). Overall, there was an 81% treatment response rate based on symptoms and a 31% response rate based on radiographic findings. Conversion to culture-negative sputum samples was achieved in 10 (24%) patients after CFZ-containing antibiotic treatment, and during treatment, there were significant decreases in the positivity of semiquantitative sputum cultures for acid-fast bacilli in both the initial (P= 0.018) and salvage (P= 0.001) treatment groups. Our study suggests that CFZ-containing regimens may improve treatment outcomes in patients withM. abscessuslung disease and that a prospective evaluation of CFZ inM. abscessuslung disease is warranted.
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Bumhee
authors.initials: B
authors.lastname: Yang
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.|Division of Pulmonary, Allergy and Critical Care Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, South Korea.
authors.forename: Byung Woo
authors.initials: BW
authors.lastname: Jhun
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Seong Mi
authors.initials: SM
authors.lastname: Moon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hyun
authors.initials: H
authors.lastname: Lee
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Hye Yun
authors.initials: HY
authors.lastname: Park
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Dae Hun
authors.initials: DH
authors.lastname: Kim
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
authors.forename: Su-Young
authors.initials: SY
authors.lastname: Kim
authors.affiliation: Department of Microbiology and Brain Korea 21 PLUS Project for Medical Science, Yonsei College of Medicine, Seoul, South Korea.
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Shin
authors.affiliation: Division of Mycobacterial and Respiratory Infections, Department of Medicine, National Jewish Health, Denver, Colorado, USA.
authors.forename: Charles L
authors.initials: CL
authors.lastname: Daley
authors.affiliation: Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea wjkoh@skku.edu.
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: D002991:Clofazimine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D008171:Lung Diseases / Q000382:microbiology*; D008826:Microbial Sensitivity Tests; D000073358:Mycobacterium abscessus / Q000187:drug effects* / Q000472:pathogenicity; D009170:Nontuberculous Mycobacteria / Q000187:drug effects / Q000472:pathogenicity; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D002991:Clofazimine
keywords: Mycobacterium abscessus; clofazimine; nontuberculous mycobacteria; treatment outcome