Treatment of pulmonary disease caused by Mycobacterium kansasii
As a cause of lung disease (LD), Mycobacterium kansasii is regarded as a highly virulent species among nontuberculous mycobacteria (NTM). Both the frequency of M. kansasii isolates and global prevalence of M. kansasii–LD have increased gradually over recent decades. Treatment of M. kansasii–LD is re...
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doaj-f8adf4a3ec214b27b748c266a3125b4a2020-11-25T03:28:15ZengElsevierJournal of the Formosan Medical Association0929-66462020-06-01119S51S57Treatment of pulmonary disease caused by Mycobacterium kansasiiHung-Ling Huang0Po-Liang Lu1Chen-Hsiang Lee2Inn-Wen Chong3Division of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, TaiwanDepartment of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung, TaiwanDivision of Infectious Diseases, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan; College of Medicine, Chang Gung University, Kaohsiung, TaiwanDivision of Pulmonary and Critical Care Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Respiratory Therapy, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Corresponding author. Department of Internal Medicine, Kaohsiung Medical University Hospital, #100, Tzyou 1st Rd., Sanmin Dist., Kaohsiung, 80756, Taiwan. Fax: +886 7 3161210.As a cause of lung disease (LD), Mycobacterium kansasii is regarded as a highly virulent species among nontuberculous mycobacteria (NTM). Both the frequency of M. kansasii isolates and global prevalence of M. kansasii–LD have increased gradually over recent decades. Treatment of M. kansasii–LD is recommended because of the disease's poor prognosis and fatal outcome. The decision on the optimal time point for treatment initiation should be based on both the benefits and risks posed by multiple antimicrobial agents.For treatment-naïve patients with M. kansasii–LD, rifampin-containing multiple antimicrobial regimens for ≥12 months after culture negative conversion are effective. However, some challenges remain, such as determining the precise length of treatment duration as well as addressing intolerable adverse effects, the uncertain effectiveness of isoniazid and ethambutol in treatment, the uncertain correlation between in vitro drug susceptibility testing and clinical outcomes, and the increasing prevalence of clarithromycin-resistant M. kansasii isolates. Short-course and effective therapies must be developed. New candidate drugs, such as tedizoid and clofazimine, exhibit excellent antimycobacterial activity against M. kansasii in vitro, but in vivo studies of their clinical applications are lacking.This paper reviews the treatment, outcomes and future directions in patients with M. kansasii–LD.http://www.sciencedirect.com/science/article/pii/S0929664620302084Mycobacterium kansasii lung diseaseMycobacterium kansasiiTreatment |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hung-Ling Huang Po-Liang Lu Chen-Hsiang Lee Inn-Wen Chong |
spellingShingle |
Hung-Ling Huang Po-Liang Lu Chen-Hsiang Lee Inn-Wen Chong Treatment of pulmonary disease caused by Mycobacterium kansasii Journal of the Formosan Medical Association Mycobacterium kansasii lung disease Mycobacterium kansasii Treatment |
author_facet |
Hung-Ling Huang Po-Liang Lu Chen-Hsiang Lee Inn-Wen Chong |
author_sort |
Hung-Ling Huang |
title |
Treatment of pulmonary disease caused by Mycobacterium kansasii |
title_short |
Treatment of pulmonary disease caused by Mycobacterium kansasii |
title_full |
Treatment of pulmonary disease caused by Mycobacterium kansasii |
title_fullStr |
Treatment of pulmonary disease caused by Mycobacterium kansasii |
title_full_unstemmed |
Treatment of pulmonary disease caused by Mycobacterium kansasii |
title_sort |
treatment of pulmonary disease caused by mycobacterium kansasii |
publisher |
Elsevier |
series |
Journal of the Formosan Medical Association |
issn |
0929-6646 |
publishDate |
2020-06-01 |
description |
As a cause of lung disease (LD), Mycobacterium kansasii is regarded as a highly virulent species among nontuberculous mycobacteria (NTM). Both the frequency of M. kansasii isolates and global prevalence of M. kansasii–LD have increased gradually over recent decades. Treatment of M. kansasii–LD is recommended because of the disease's poor prognosis and fatal outcome. The decision on the optimal time point for treatment initiation should be based on both the benefits and risks posed by multiple antimicrobial agents.For treatment-naïve patients with M. kansasii–LD, rifampin-containing multiple antimicrobial regimens for ≥12 months after culture negative conversion are effective. However, some challenges remain, such as determining the precise length of treatment duration as well as addressing intolerable adverse effects, the uncertain effectiveness of isoniazid and ethambutol in treatment, the uncertain correlation between in vitro drug susceptibility testing and clinical outcomes, and the increasing prevalence of clarithromycin-resistant M. kansasii isolates. Short-course and effective therapies must be developed. New candidate drugs, such as tedizoid and clofazimine, exhibit excellent antimycobacterial activity against M. kansasii in vitro, but in vivo studies of their clinical applications are lacking.This paper reviews the treatment, outcomes and future directions in patients with M. kansasii–LD. |
topic |
Mycobacterium kansasii lung disease Mycobacterium kansasii Treatment |
url |
http://www.sciencedirect.com/science/article/pii/S0929664620302084 |
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