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논문 기본 정보

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학술저널
저자정보
Yong Shik Kwon (Department of Internal Medicine Keimyung University Dongsan Medical Center) Byoung Soo Kwon (Seoul National University College of Medicine) Ock-hwa Kim (University of Ulsan College of Medicine) Yea Eun Park (University of Ulsan College of Medicine) Tae Sun Shim (Department of Pulmonary and Critical Care Medicine Asan Medical Center University of Ulsan College) Yong Pil Chong (Department of Infectious Diseases Asan Medical Center University of Ulsan College of Medicine) 조경욱 (서울아산병원)
저널정보
대한의학회 Journal of Korean Medical Science Journal of Korean Medical Science Vol.35 No.9
발행연도
2020.1
수록면
1 - 11 (11page)

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Background: Long-term administration of ethambutol (EMB) for Mycobacterium avium complex lung disease (MAC-LD) sometimes leads to permanent discontinuation of EMB due to various adverse events. This study aimed to investigate treatment outcomes after discontinuation of EMB. Methods: Among patients diagnosed with MAC-LD between January 2001 and December 2014, 508 patients whose treatment was initiated with standard regimen until May 2018 were enrolled at a tertiary referral center in Korea. Of these 508 patients, 60 (11.8%) discontinued EMB due to various adverse effects. Among these 60 patients, treatment outcomes were analyzed for 44 patients by comparing their outcomes with those of matched subjects who received the standard treatment regimen without EMB discontinuation. Results: The mean age of the 60 patients who discontinued EMB was 64.4 years. Ocular toxicity was the most common cause of discontinuation of EMB (75.0%, 45/60). The mean duration of EMB administration before its discontinuation was 7.0 ± 4.6 months. The treatment failure rate of the 44 patients with EMB discontinuation analyzed for treatment outcome was 29.6%, which was higher than that of the matched patients who received the standard regimen (18.3%), although the difference was not significant (P = 0.095). Of these 44 patients, EMB was substituted with later-generation fluoroquinolone in 23 patients, and the treatment failure rate of these 23 patients was significantly higher than that of the matched patients who received the standard regimen (39.1% vs. 19.3%, P = 0.045). Conclusion: These findings suggest that treatment outcomes are unsatisfactory in patients with MAC-LD who discontinue EMB owing to adverse events. Notably, there was a statistically significant high failure rate in patients who were prescribed fluoroquinolone to replace EMB.
#Mycobacterium avium #Lung Disease #Ethambutol #Treatment Outcome #Fluoroquinolones

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참고문헌 (29)

참고문헌 신청
권용수 / 2016 / Diagnosis and Treatment of Nontuberculous Mycobacterial Lung Disease / Journal of Korean Medical Science 31(5):649~659 dbpia Ko RE / 2018 / Changing epidemiology of nontuberculous mycobacterial lung diseases in a tertiary referral hospital in Korea between 2001 and 2015 / J Korean Med Sci 33(8):e65 google schola 권용수 / 2019 / Treatment of Mycobacterium avium Complex Pulmonary Disease / Tuberculosis and Respiratory Diseases 82(1):15~26 google schola Griffith DE / 2007 / An official ATS/IDSA statement : diagnosis, treatment, and prevention of nontuberculous mycobacterial diseases / Am J Respir Crit Care Med 175(4):367~416 google schola Griffith DE / 2005 / Ethambutol ocular toxicity in treatment regimens for Mycobacterium avium complex lung disease / Am J Respir Crit Care Med 172(2):250~253 google schola

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