Association Between Duration of Aminoglycoside Treatment and Outcome of Cavitary Mycobacterium avium Complex Lung Disease

2018 ◽  
Vol 68 (11) ◽  
pp. 1870-1876 ◽  
Author(s):  
Ock-Hwa Kim ◽  
Byoung Soo Kwon ◽  
Minkyu Han ◽  
Younsuck Koh ◽  
Woo-Sung Kim ◽  
...  
Keyword(s):  
Lung Disease ◽  
Success Rate ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Duration Of Treatment ◽  
Tertiary Referral Center ◽  
End Of Treatment ◽  
Attending Physician

Abstract Background Although aminoglycosides are recommended for cavitary Mycobacterium avium complex lung disease (MAC-LD), the optimal duration of treatment is unclear. We investigated the association between duration of aminoglycoside treatment and outcomes in cavitary MAC-LD. Methods Among patients diagnosed with macrolide-susceptible cavitary MAC-LD between 2000 and 2013, 101 who received treatment up to August 2017 with a regimen containing aminoglycosides were enrolled at a tertiary referral center in South Korea. Their medical records were retrospectively reviewed. The duration of aminoglycoside treatment was at the discretion of the attending physician. Results A total of 75 patients (74.3%) were administered aminoglycosides for ≥3 months (median 164 days), whereas the remaining 26 patients (25.7%) received treatment for <3 months (median 59 days). The overall treatment success rate was 63.4% (64/101). Patients treated with aminoglycosides for ≥3 months had a significantly higher success rate than those treated for <3 months (69.3% vs 46.2%; P = .035). Multivariate analysis revealed that aminoglycoside treatment for ≥3 months was a significant factor for treatment success (adjusted odds ratio, 3.602; 95% confidence interval, 1.249–10.390; P = .018). Recurrence occurred in 8 (22.9%) of 35 patients who were followed up for at least 3 years after the end of treatment; all 8 patients received aminoglycosides for ≥3 months. Conclusions Patients with cavitary MAC-LD treated with aminoglycosides for ≥3 months showed higher treatment success rate than those treated for <3 months. However, treatment for ≥3 months was not associated with the development of recurrence.

scholarly journals In VitroMIC Values of Rifampin and Ethambutol and Treatment Outcome inMycobacterium aviumComplex Lung Disease

2018 ◽  
Vol 62 (10) ◽  
Author(s):  
Byoung Soo Kwon ◽  
Mi-Na Kim ◽  
Heungsup Sung ◽  
Younsuck Koh ◽  
Woo-Sung Kim ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Lung Disease ◽  
Success Rate ◽  
Antimicrobial Agents ◽  
Treatment Success ◽  
Treatment Success Rate ◽  
Standard Regimen ◽  
Content Type ◽  
Broth Microdilution Method

ABSTRACTAlthough it is known that thein vitroMICs of rifampin and ethambutol are poorly correlated with the clinical response inMycobacterium aviumcomplex (MAC) lung disease (MAC-LD), evidence for this is limited. This study investigated the association between treatment outcome and thein vitroMICs of rifampin and ethambutol in patients with MAC-LD. Among patients diagnosed with macrolide-susceptible MAC-LD between January 2008 and December 2013, 274 patients who were treated with a standard regimen for ≥12 months until August 2017 and whosein vitroMIC results were available were enrolled at a tertiary referral center in South Korea. The MICs of antimicrobial agents were determined using the broth microdilution method. The mean age of the included patients was 60.4 years. The overall treatment success rate was 79.6% (218/274 patients) and tended to decrease with increasing MICs of rifampin and ethambutol, particularly at MICs of ≥8 μg/ml. Treatment success rate was significantly different between MAC isolates with MICs of ≥8 μg/ml for rifampin and ethambutol and those with MICs of <8 μg/ml for rifampin and/or ethambutol (64.9% versus 85.3%,P< 0.001). Multivariate analysis showed that an MIC of ≥8 μg/ml for both drugs and initial sputum acid-fast bacillus (AFB) smear positivity were independent risk factors for an unfavorable response (adjusted odds ratio [OR] = 3.154, 95% confidence interval [CI] = 1.641 to 6.063, andP= 0.001 for an MIC of ≥8 μg/ml; adjusted OR = 2.769, 95% CI = 1.420 to 5.399, andP= 0.003 for initial sputum AFB smear positivity). These findings suggest that thein vitroMICs of rifampin and ethambutol may be related to treatment outcome in MAC-LD.

scholarly journals Effect of using electronic medication monitors on tuberculosis treatment outcomes in China: a longitudinal ecological study

2021 ◽  
Vol 10 (1) ◽  
Author(s):  
Ni Wang ◽  
Lei Guo ◽  
Hemant Deepak Shewade ◽  
Pruthu Thekkur ◽  
Hui Zhang ◽  
...  
Keyword(s):  
Success Rate ◽  
Treatment Outcomes ◽  
Treatment Success ◽  
Coverage Rate ◽  
Treatment Success Rate ◽  
County Level ◽  
Time Data ◽  
Tb Treatment ◽  
Random Intercept ◽  
Relative Change

Abstract Background In China, an indigenously developed electronic medication monitor (EMM) was designed and used in 138 counties from three provinces. Previous studies showed positive results on accuracy, effectiveness, acceptability, and feasibility, but also found some ineffective implementations. In this paper, we assessed the effect of implementation of EMMs on treatment outcomes. Methods The longitudinal ecological method was used at the county level with aggregate secondary programmatic data. All the notified TB cases in 138 counties were involved in this study from April 2017 to June 2019, and rifampicin-resistant cases were excluded. We fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate, in which a mixed effects maximum likelihood regression using random intercept model was applied, by adjusting for seasonal trends, population size, sociodemographic and clinical characteristics, and clustering within counties. Results Among all 69 678 notified TB cases, the treatment success rate was slightly increased from 93.5% [95% confidence interval (CI): 93.0–94.0] in second quarter of 2018 to 94.9% (95% CI: 94.4–95.4) in second quarter of 2019 after implementing EMMs. There was a statistically significant effect between quarterly EMM coverage and treatment success rate after adjusting for potential confounders (P = 0.0036), increasing 10% of EMM coverage rate will lead to 0.2% treatment success rate augment. Besides, an increase of 10% of elderly or bacteriologically confirmed TB will lead to a decrease of 0.4% and 0.9% of the treatment success rate. Conclusions Under programmatic settings, we found a statistically significant effect between increasing coverage of EMM and treatment success rate at the county level. More prospective studies are needed to confirm the effect of using EMM on TB treatment outcomes. We suggest performing operational research on EMMs that provides real-time data under programmatic conditions in the future.

scholarly journals Lower airway microbiota in patients with clinically suspected Mycobacterium avium complex lung disease

Heliyon ◽  
2021 ◽  
pp. e07283
Author(s):  
Kotaro Iwasaki ◽  
Yasuo Matsuzawa ◽  
Hiroki Wakabayashi ◽  
Moe Shioya ◽  
Sho Hayakawa ◽  
...  
Keyword(s):  
Lung Disease ◽  
Mycobacterium Avium ◽  
Mycobacterium Avium Complex ◽  
Lower Airway

Relationship between malocclusion severity and treatment success rate in Class II nonextraction therapy

2009 ◽  
Vol 135 (3) ◽  
pp. 274-275 ◽  
Author(s):  
Guilherme Janson ◽  
Fabrício Pinelli Valarelli ◽  
Rodrigo Hermont Cançado ◽  
Marcos Roberto de Freitas ◽  
Arnaldo Pinzan
Keyword(s):  
Success Rate ◽  
Treatment Success ◽  
Class Ii ◽  
Treatment Success Rate
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