TABLE 2

Combination antimycobacterial chemotherapy and other clinical interventions examined by selected studiesa

ReferenceNo. of patients treatedType of infectioncerm(41) gene deletion (no. of patients/total no.)No. of patients with CF, AAT, or CDbMacrolide(s) usedAminoglycoside(s) useddOther antibiotics used in combination therapy; no. of patients who received surgeryDuration, moe (range)
TherapyFollow-up
Macrolide-free regimens
    Griffith et al. (21)120120 NSSNA9 CFNonei.v. AMK, dailyFOX, IPM, SXT, ERY, other anti-TB drugs; 7NA58.8 ± 4.8
Macrolide-containing regimens
    van Ingen et al. (32)129 M. abscessus subsp. abscessus, 2 M. abscessus subsp. massiliense, 1 M. abscessus subsp. bolletiiNA4 CFCLRi.v. AMK, dailyFOX, IPM, SXT, LVX, and first-line anti-TB drugs; 113NA
    Jeon et al. (14)8686 NSSNANACLR1/12 i.v. AMK, twice dailyFOX, IPM, CIP, DOX; 1424.4 ± 0.212 (5–30)
    Jarand et al. (23)107107 M. abscessus subsp. abscessusNA25 CF, 1 AATAZM, CLR3/12 i.v. AMKFOX, IPM, LVX, SXT and others, individualized based on DST; 2452 ± 40.634 ± 21.1
    Lyu et al. (26)4141 NSSNANAAZM, CLR8/12 i.v. AMK, once dailyFOX, IPM, DOX, quinolones (CIP, MXF); 1317.03 (5.46–41.63)14.83 (0–48.1)
    Koh et al. (15)6730 M. abscessus subsp. Abscessus, 37 M. abscessus subsp. massiliense0/19 M. abscessus subsp. abscessus, 28/28 M. abscessus subsp. massilienseNACLR1/12 i.v., AMK twice dailyFOX, IPM, DOX, CIP; 023.1 ± 12.9 M. abscessus subsp. abscessus, 21.6 ± 7.7 M. abscessus subsp. massilienseNA
    Harada et al. (22)6442 M. abscessus subsp. abscessus, 20 M. abscessus subsp. massiliense, 2 M. abscessus subsp. bolletiiNANAAZM, CLR, ERYi.v. STP, AMK, KANFOX, IPM, DOX, quinolones (CIP, MXF); anti-TB drugs; 633 (3–178) M. abscessus subsp. abscessus, 36 (1–122) M. abscessus subsp. massiliense, 36 (4–68) M. abscessus subsp. bolletii25 (1–120) M. abscessus subsp. abscessus, 18 (1–62) M. abscessus subsp. massiliense
    Tung et al. (31)5656 M. abscessus subsp. abscessusNANACLRi.v. AMKFOX, IPM, MEM, DOX, quinolones (CIP, MXF); anti-TB drugs; 012NA
    Griffith et al. (7)1111 M. abscessus subsp. abscessusNANAAZM, CLRi.v. AMKFOX, IPMNA48.3 ± 28.7
    Namkoong et al. (27)1313 M. abscessus subsp. abscessusNANACLRi.v. AMK, thrice weeklyFaropenem, sitafloxacin, MIN, IPM; 021.31 ± 2.1012
    Koh et al. (25)7171 M. abscessus subsp. massiliense16/16NAAZM, CLRi.v. AMK2-wk regimen of FOX, IPM; 3; 4-wk regimen of FOX, IPM, quinolones (CIP, MXF); 22-wk regimen, 15.2 (12.7–18.1); 4-wk regimen, 23.9 (23.1–24.1)2-wk regimen, 14.7 (0.5–29.5); 4-wk regimen, 33.8 (12.3–50.3)
    Czaja et al. (20)4747 M. abscessus subsp. abscessusNA9 CF, 5 AATAZM9/12 i.v. and inhalation AMK dailyFOX, IPM, quinolones, CFO; 1617.3 ± 6.624.97 ± 1.40
    Koh et al. (24)6767 M. abscessus subsp. abscessus7/44NAAZM, CLRi.v. AMKFOX, IPM, quinolones (CIP, MXF), DOX; 9>12 mo11.8 (3.6–27)
    Park et al. (30)11356 M. abscessus subsp. abscessus, 54 M. abscessus subsp. massiliense, 3 mixed27/56 (M. abscessus subsp. abscessus), 3/54 (M. abscessus subsp. massiliense)NAAZM, CLRi.v. AMK, 3–5 times weeklyFOX, IPM; 5 (3 M. abscessus subsp. abscessus, 2 M. abscessus subsp. massiliense)15.25 (7–29) M. abscessus subsp. Abscessus, 21.75 (16–30) M. abscessus subsp. massiliense42.13 ± 22.47
    Macrolide-containing regimen plus investigational drugs
    Olivier et al. (29)1510 M. abscessus subsp. abscessus, 5 M. abscessus subsp. massiliense11/152 CF, 1 CDCLRNebulized AMKAMK nebulized 250 mg/ml daily; CLR given daily60 (6–190)19 (1–50)
    Wallace et al. (33)3434 NSS22 CFAZM, CLRAMK, tobramycinFOX, IPM, MEM, quinolones (CIP, MXF), EMB, SXT; 38.5 ± 8.86NA
    Yang et al. (34)4242 M. abscessus subsp. abscessus7/42NAAZM4/52 i.v. AMK dailyInitial CLO therapy of FOX, IPM; 1; salvage CLO therapy added to existing regimen (quinolones [CIP, MXF], FOX, IPM); 2Both treatment groups, 48.0 (24.8–48.0)12.0
    Olivier et al. (28)3232 NSSNA14 CFAZM, CLR3/12 liposomal AMK daily, Tobramycin15 patients on intervention regimen of FOX, IPM, MEM, quinolones (CIP, MXF, LVF), DOX, linezolid, CLO, anti-TB drugs; 0; 17 patients on placebo regimen of FOX, IPM, MEM, quinolone (CIP, MXF, LVF), DOX, linezolid, CLO, TGC, anti-TB drugs; 0>2412
    Choi et al. (19)1515 M. abscessus subsp. massiliense (all macrolide resistant)14/15NAAZM, CLRi.v. and inhalation AMK dailyFOX, IPM, quinolone (CIP, MXF), DOX, SXT; 3 surgeryPrior macrolide, 10 (IQR, 4–17) versus 18.7 (IQR, 11.2–39.8)38.7 (IQR, 11.4–41.9)
  • a Antibiotic or drug abbreviations: AMK, amikacin; AZM, azithromycin; CIP, ciprofloxacin; CLO, clofazimine; CLR, clarithromycin; DOX, doxycycline; EMB, ethambutol; ERY, erythromycin; FOX, cefoxitin; IPM, imipenem; LVX, levofloxacin; MEM, meropenem; MIN, minocycline; MXF, moxifloxacin; SXT, trimethoprim-sulfamethoxazole; TGC, tigecycline.

  • b CF, cystic fibrosis; AAT, abnormal α-1 antitrypsin; CD, ciliary dyskinesia; NA, data not available.

  • c NSS, M. abscessus subspecies not specified.

  • d i.v., intravenous.

  • e IQR, interquartile range.