ArticleBMC pulmonary medicine2025
Clinical efficacy of sitafloxacin-containing regimens for Mycobacterium avium complex pulmonary disease.
Article in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundFluoroquinolones (FQ) have shown efficacy against Mycobacterium avium complex (MAC) across experimental settings, in vitro and in vivo. Sitafloxacin (STFX) has demonstrated particularly strong anti-MAC activity, but clinical data on its effectiveness in treating MAC pulmonary disease (MAC-PD) are sparse. This study aimed to evaluate the efficacy of STFX-containing regimens in patients with MAC-PD.
methodsThis retrospective cohort study included 50 patients with MAC-PD who received STFX-containing regimens for ≥6 months at a single center between January 2015 and March 2024. Patients were categorized into four groups: Group 1, STFX-treated without surgery (n = 49); Group 2, STFX started ≥6 months after guideline-based treatment (GBT) began (n = 40); Group 3, poor radiologic response to GBT (n = 38); and Group 4, persistent positive sputum cultures at STFX initiation (n = 19). Primary outcomes assessed at six months included radiologic improvement using the NICE (Nodule, Infiltration, Cavity, Ectasis) score, sputum culture conversion (defined as ≥2 consecutive negative cultures obtained ≥4 weeks apart), and symptom improvement (using the COPD Assessment Test [CAT] score).
resultsRadiologic improvement, symptomatic improvement, and sputum culture conversion were observed in 18.4%, 19.1%, and 20.0% of patients in Group 1; 12.5%, 20.0%, and 12.5% in Group 2; 13.2%, 18.4%, and 13.3% in Group 3; and 5.3%, 15.8%, and 12.5% (2 of 16 evaluable patients) in Group 4, respectively. The two patients who achieved culture conversion had clarithromycin-susceptible strains, non-cavitary disease, and received concomitant ethambutol.
conclusionsSTFX-containing regimens demonstrated modest and overall limited efficacy in patients with MAC-PD, with fewer than 20% achieving radiologic, symptomatic, or microbiological improvement across all groups. STFX may be considered an alternative adjunct when standard therapies are not feasible; however, its overall therapeutic role appears limited.
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