Mycobacterium Abscessus 폐질환의 치료
Treatment of Mycobacterium Abscessus Pulmonary Disease
전병우, 고원중,
소속 상세정보
전병우 ( Jhun Byung-Woo )
성균관대학교 의과대학 내과학교실
고원중 ( Koh Won-Jung )
성균관대학교 의과대학 내과학교실
Abstract
Mycobacterium abscessus is the second most important pathogen in pulmonary disease caused by nontuberculous mycobacteria (NTM), following Mycobacterium avium. Mycobacterium abscessus is classified into three subspecies: M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii. Mycobacterium abscessus is the most difficult to treat NTM due to its resistance to many antibiotics. Treatment should include an initial regimen of 2-3 injectable and oral antibiotics for several weeks or months, followed by inhaled amikacin and 1-3 oral antibiotics, depending on the subspecies and drug susceptibility patterns, including macrolide susceptibility. The continuation phase should be continued for a minimum of 12 months after culture conversion. Suitable injectable antibiotics include amikacin, imipenem, cefoxitin, and tigecycline, while oral antibiotics include macrolides (azithromycin or clarithromycin), clofazimine, linezolid, and moxifloxacin. Surgery can be a useful adjunctive therapy for some patients with refractory disease. However, the overall treatment prognosis is still unsatisfactory. Therefore, novel and more effective interventions are required for the treatment of M. abscessus pulmonary disease.
키워드
Nontuberculous mycobacteria; Mycobacterium abscessus; Treatment; Anti-bacterial agents
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