Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease

Byung Woo Jhun; Seong Mi Moon; Su Young Kim; Hye Yun Park; Kyeongman Jeon; O. Jung Kwon; Hee Jae Huh; Chang Seok Ki; Nam Yong Lee; Myung Jin Chung; Kyung Soo Lee; Sung Jae Shin; Charles L. Daley; Won Jung Koh

doi:10.1128/AAC.01812-17

Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease

Byung Woo Jhun, Seong Mi Moon, Su Young Kim, Hye Yun Park, Kyeongman Jeon, O. Jung Kwon, Hee Jae Huh, Chang Seok Ki, Nam Yong Lee, Myung Jin Chung, Kyung Soo Lee, Sung Jae Shin, Charles L. Daley, Won Jung Koh

Department of Microbiology

Research output: Contribution to journal › Article › peer-review

14 Citations (Scopus)

Abstract

Intermittent, three-times-weekly oral antibiotic therapy is recommended for the initial treatment of noncavitary nodular bronchiectatic (NB) Mycobacterium avium complex (MAC) lung disease. However, intermittent therapy is not recommended for patients who have been previously treated. We evaluated 53 patients with recurrent noncavitary NB MAC lung disease who underwent antibiotic treatment for ≥12 months with daily therapy (n = 26) or intermittent therapy (n = 27) between January 2008 and December 2015. Baseline characteristics were comparable between daily therapy and intermittent therapy groups. Sputum culture conversion rates did not differ between daily therapy (21/26, 81%) and intermittent therapy (22/27, 82%) groups. Compared to the etiologic organism at the time of previous treatment, recurrent MAC lung disease was caused by the same MAC species in 38 patients (72%) and by a different MAC species in 15 patients (28%). Genotype analysis in patients with sequenced paired isolates revealed that 86% (12/14) of cases with same species recurrence were due to reinfection with a new MAC genotype. In conclusion, most recurrent noncavitary NB MAC lung disease cases were caused by reinfection rather than relapse. Intermittent antibiotic therapy is a reasonable treatment strategy for recurrent noncavitary NB MAC lung disease.

Original language	English
Article number	e01812-17
Journal	Antimicrobial agents and chemotherapy
Volume	62
Issue number	2
DOIs	https://doi.org/10.1128/AAC.01812-17
Publication status	Published - 2018 Feb

Bibliographical note

Funding Information:
We thank Soohyun Ahn, a statistician in Samsung Medical Center, for help with the statistical analysis. C.L.D. received grants from Insmed, Inc., not associated with the submitted work. Otherwise, we have no conflicts of interest to declare. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2015R1A2A1A01003959) and by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, collection, and analysis of the data, or preparation of the manuscript.

Funding Information:
for her help in statistical analysis. Dr. Charles L. Daley has received grants from Insmed Inc.

Publisher Copyright:
Copyright © 2018 American Society for Microbiology. All Rights Reserved.

All Science Journal Classification (ASJC) codes

Pharmacology
Pharmacology (medical)
Infectious Diseases

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1128/AAC.01812-17

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Jhun, B. W., Moon, S. M., Kim, S. Y., Park, H. Y., Jeon, K., Jung Kwon, O., Huh, H. J., Ki, C. S., Lee, N. Y., Chung, M. J., Lee, K. S., Shin, S. J., Daley, C. L., & Koh, W. J. (2018). Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease. Antimicrobial agents and chemotherapy, 62(2), [e01812-17]. https://doi.org/10.1128/AAC.01812-17

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title = "Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease",

abstract = "Intermittent, three-times-weekly oral antibiotic therapy is recommended for the initial treatment of noncavitary nodular bronchiectatic (NB) Mycobacterium avium complex (MAC) lung disease. However, intermittent therapy is not recommended for patients who have been previously treated. We evaluated 53 patients with recurrent noncavitary NB MAC lung disease who underwent antibiotic treatment for ≥12 months with daily therapy (n = 26) or intermittent therapy (n = 27) between January 2008 and December 2015. Baseline characteristics were comparable between daily therapy and intermittent therapy groups. Sputum culture conversion rates did not differ between daily therapy (21/26, 81%) and intermittent therapy (22/27, 82%) groups. Compared to the etiologic organism at the time of previous treatment, recurrent MAC lung disease was caused by the same MAC species in 38 patients (72%) and by a different MAC species in 15 patients (28%). Genotype analysis in patients with sequenced paired isolates revealed that 86% (12/14) of cases with same species recurrence were due to reinfection with a new MAC genotype. In conclusion, most recurrent noncavitary NB MAC lung disease cases were caused by reinfection rather than relapse. Intermittent antibiotic therapy is a reasonable treatment strategy for recurrent noncavitary NB MAC lung disease.",

author = "Jhun, {Byung Woo} and Moon, {Seong Mi} and Kim, {Su Young} and Park, {Hye Yun} and Kyeongman Jeon and {Jung Kwon}, O. and Huh, {Hee Jae} and Ki, {Chang Seok} and Lee, {Nam Yong} and Chung, {Myung Jin} and Lee, {Kyung Soo} and Shin, {Sung Jae} and Daley, {Charles L.} and Koh, {Won Jung}",

note = "Funding Information: We thank Soohyun Ahn, a statistician in Samsung Medical Center, for help with the statistical analysis. C.L.D. received grants from Insmed, Inc., not associated with the submitted work. Otherwise, we have no conflicts of interest to declare. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2015R1A2A1A01003959) and by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, collection, and analysis of the data, or preparation of the manuscript. Funding Information: for her help in statistical analysis. Dr. Charles L. Daley has received grants from Insmed Inc. Publisher Copyright: Copyright {\textcopyright} 2018 American Society for Microbiology. All Rights Reserved.",

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AU - Jhun, Byung Woo

AU - Moon, Seong Mi

AU - Kim, Su Young

AU - Park, Hye Yun

AU - Jeon, Kyeongman

AU - Jung Kwon, O.

AU - Huh, Hee Jae

AU - Ki, Chang Seok

AU - Lee, Nam Yong

AU - Chung, Myung Jin

AU - Lee, Kyung Soo

AU - Shin, Sung Jae

AU - Daley, Charles L.

AU - Koh, Won Jung

N1 - Funding Information: We thank Soohyun Ahn, a statistician in Samsung Medical Center, for help with the statistical analysis. C.L.D. received grants from Insmed, Inc., not associated with the submitted work. Otherwise, we have no conflicts of interest to declare. This research was supported by the Basic Science Research Program through the National Research Foundation of Korea funded by the Ministry of Science, ICT, and Future Planning (NRF-2015R1A2A1A01003959) and by a grant from the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (HI15C2778). The sponsor had no role in the design of the study, collection, and analysis of the data, or preparation of the manuscript. Funding Information: for her help in statistical analysis. Dr. Charles L. Daley has received grants from Insmed Inc. Publisher Copyright: Copyright © 2018 American Society for Microbiology. All Rights Reserved.

PY - 2018/2

Y1 - 2018/2

N2 - Intermittent, three-times-weekly oral antibiotic therapy is recommended for the initial treatment of noncavitary nodular bronchiectatic (NB) Mycobacterium avium complex (MAC) lung disease. However, intermittent therapy is not recommended for patients who have been previously treated. We evaluated 53 patients with recurrent noncavitary NB MAC lung disease who underwent antibiotic treatment for ≥12 months with daily therapy (n = 26) or intermittent therapy (n = 27) between January 2008 and December 2015. Baseline characteristics were comparable between daily therapy and intermittent therapy groups. Sputum culture conversion rates did not differ between daily therapy (21/26, 81%) and intermittent therapy (22/27, 82%) groups. Compared to the etiologic organism at the time of previous treatment, recurrent MAC lung disease was caused by the same MAC species in 38 patients (72%) and by a different MAC species in 15 patients (28%). Genotype analysis in patients with sequenced paired isolates revealed that 86% (12/14) of cases with same species recurrence were due to reinfection with a new MAC genotype. In conclusion, most recurrent noncavitary NB MAC lung disease cases were caused by reinfection rather than relapse. Intermittent antibiotic therapy is a reasonable treatment strategy for recurrent noncavitary NB MAC lung disease.

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Intermittent antibiotic therapy for recurrent nodular bronchiectatic mycobacterium avium complex lung disease

Abstract

Bibliographical note

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UN SDGs

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