ArticleBMC pulmonary medicine2019
Role of ethambutol and rifampicin in the treatment of Mycobacterium avium complex pulmonary disease.
Article in BMC pulmonary medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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Who cites it
34 citing papers in PubMed, 56 citations in OpenAlex.
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- Efficacies of sequenced monotherapies ofbioRxiv : the preprint server for biology · 2025Article
- Nontuberculous Mycobacterial Lung Disease Management in Belgium: A Longitudinal Pharmacy Database Study.Drugs - real world outcomes · 2025Article
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- Investigation of WQ-3810, a Fluoroquinolone with a High Potential Against Fluoroquinolone-ResistantAntibiotics (Basel, Switzerland) · 2025Article
- Current and emerging treatment strategies forEwha medical journal · 2025Review
- Creation of a macrolide antibiotic against non-tuberculousScience advances · 2025Article
- Pulmonary Delivery of Antibiotics to the Lungs: Current State and Future Prospects.Pharmaceutics · 2025Review
- Chemical optimization and derivatization of micrococcin p2 to target multiple bacterial infections: new antibiotics from thiopeptides.World journal of microbiology & biotechnology · 2024Review
- Minimum inhibitory concentrations of azithromycin in clinical isolates ofMicrobiology spectrum · 2024Article
- Treatment Outcomes of Clofazimine-Containing Regimens in SevereOpen forum infectious diseases · 2024Article
- QSPR analysis of distance-based structural indices for drug compounds in tuberculosis treatment.Heliyon · 2024Article
- MptpB Inhibitor Improves the Action of Antibiotics againstACS infectious diseases · 2024Article
- Applications and advances in molecular diagnostics: revolutionizing non-tuberculous mycobacteria species and subspecies identification.Frontiers in public health · 2024Review
- Intracellular and in vivo activities of oxazolidinone drugs against Mycobacterium avium complex infection.Scientific reports · 2023Article
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Authors and funding
7 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundA three-drug regimen (macrolide, ethambutol, and rifampicin) is recommended for the treatment of Mycobacterium avium complex pulmonary disease (MAC-PD). Although macrolide has proven efficacy, the role of ethambutol and rifampicin in patients without acquired immune deficiency syndrome is not proven with clinical studies. We aimed to clarify the roles of ethambutol and rifampicin in the treatment of MAC-PD.
methodsPatients treated for MAC-PD between March 1st, 2009 and October 31st, 2018 were reviewed retrospectively. Rates of culture conversion, microbiological cure, treatment failure, and recurrence were compared according to the maintenance (≥6 months) of ethambutol or rifampicin with macrolide.
resultsAmong the 237 patients, 122 (51.5%) maintained ethambutol and rifampicin with macrolide, 58 (24.5%) maintained ethambutol and macrolide, 32 (13.5%) maintained rifampicin and macrolide, and 25 (10.6%) maintained macrolide only. Culture conversion was reached for 190/237 (80.2%) patients and microbiological cure was achieved for 129/177 (72.9%) who completed the treatment. Treatment failure despite ≥12 months of treatment was observed in 66/204 (32.4%), and recurrence was identified in 16/129 (12.4%) who achieved microbiological cure. Compared with maintenance of macrolide only, maintenance of ethambutol, rifampicin or both with macrolide were associated with higher odds of culture conversion [odds ratio (OR), 95% confidence interval (CI): 18.06, 3.67-88.92; 15.82, 2.38-105.33; and 17.12, 3.93-74.60, respectively]. Higher odds of microbiological cure were associated with maintenance of both ethambutol and rifampicin with macrolide (OR, 95% CI: 5.74, 1.54-21.42) and macrolide and ethambutol (OR, 95% CI: 5.12, 1.72-15.24) but not macrolide and rifampicin. Maintenance of both ethambutol and rifampicin with macrolide was associated with lower odds of treatment failure (OR, 95% CI: 0.09, 0.01-0.53) compared with macrolide only, while maintenance of one of these with macrolide was not. Maintenance of both ethambutol and rifampicin or one of these with macrolide did not decrease the probability of recurrence when compared with macrolide only.
conclusionsMaintenance (≥6 months) of ethambutol and rifampicin with macrolide was associated with the most favorable treatment outcomes among patients with MAC-PD. Given the association between ongoing ethambutol use and microbiological cure, clinicians should maintain ethambutol unless definite adverse events develop.
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