PMID- 33436352
OWN - NLM
STAT- MEDLINE
DCOM- 20210820
LR  - 20210820
IS  - 2212-5353 (Electronic)
IS  - 2212-5345 (Linking)
VI  - 59
IP  - 2
DP  - 2021 Mar
TI  - Resumption/efficacy and safety of an azithromycin-containing regimen against 
      Mycobacterium avium complex lung disease in patients who experienced adverse 
      effects with a clarithromycin-containing regimen.
PG  - 212-217
LID - S2212-5345(20)30137-4 [pii]
LID - 10.1016/j.resinv.2020.09.010 [doi]
AB  - BACKGROUND: Antibiotic therapy, including clarithromycin (CLR), has been widely 
      used for the management of Mycobacterium avium complex (MAC) lung disease in 
      clinical settings. When patients develop adverse events (AEs) during CLR-based 
      treatment, the treatment regimen is modified or chemotherapy itself is 
      discontinued. The need for alternative macrolide treatment strategies is 
      emphasized due to the high rate of AEs possibly caused by CLR. Thus, the current 
      study aimed to examine the efficacy and safety of azithromycin (AZM) in patients 
      with MAC lung disease whose treatment was switched from CLR to AZM. METHODS: We 
      performed a retrospective study of patients with MAC lung disease. The inclusion 
      criteria were as follows: (1) patients who experienced AEs during treatment with 
      antibiotics, including CLR, between December 2012 and November 2017, and (2) 
      those who had antimicrobial therapy that was switched from CLR to AZM. The 
      efficacy and safety of AZM during the clinical course of the disease after 
      switching the regimen from CLR to AZM were investigated. RESULTS: Antibiotic 
      therapy was switched in 31 patients who presented with AEs including drug-induced 
      fever, rash, dysgeusia, liver dysfunction, and neutropenia during treatment with 
      CLR-containing regimens. After switching to AZM, the median duration of treatment 
      was 1286 (364-4615) days. During follow-up, 13 patients had a negative conversion 
      of sputum culture. CONCLUSIONS: AZM may be safe and effective for patients with 
      MAC lung disease who have difficulty tolerating CLR. In patients who experienced 
      AEs possibly caused by CLR, switching from CLR to AZM might be an appropriate 
      strategy.
CI  - Copyright (c) 2020 The Japanese Respiratory Society. Published by Elsevier B.V. All 
      rights reserved.
FAU - Kobayashi, Takehiko
AU  - Kobayashi T
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan. Electronic address: cobberfield@yahoo.co.jp.
FAU - Tsuyuguchi, Kazunari
AU  - Tsuyuguchi K
AD  - Department of Infectious Diseases, Clinical Research Center, National Hospital 
      Organization Kinki-Chuo Chest Medical Center, Japan. Electronic address: 
      tsuyuguchi.kazunari.ky@mail.hosp.go.jp.
FAU - Yoshida, Shiomi
AU  - Yoshida S
AD  - Department of Infectious Diseases, Clinical Research Center, National Hospital 
      Organization Kinki-Chuo Chest Medical Center, Japan.
FAU - Kimura, Yohei
AU  - Kimura Y
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan; Department of Pulmonary Medicine, Awaji Medical Center, 
      Japan.
FAU - Tsuji, Taisuke
AU  - Tsuji T
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan; Department of Pulmonary Medicine, Japanese Red Cross Kyoto 
      Daiichi Hospital, Japan.
FAU - Minomo, Shojiro
AU  - Minomo S
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan.
FAU - Kurahara, Yu
AU  - Kurahara Y
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan.
FAU - Inoue, Yoshikazu
AU  - Inoue Y
AD  - Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical 
      Center, Japan.
FAU - Suzuki, Katsuhiro
AU  - Suzuki K
AD  - Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest 
      Medical Center, Japan.
LA  - eng
PT  - Journal Article
DEP - 20210109
PL  - Netherlands
TA  - Respir Investig
JT  - Respiratory investigation
JID - 101581124
RN  - 0 (Anti-Bacterial Agents)
RN  - 83905-01-5 (Azithromycin)
RN  - H1250JIK0A (Clarithromycin)
SB  - IM
MH  - Anti-Bacterial Agents/*administration & dosage/*adverse effects
MH  - Azithromycin/*administration & dosage
MH  - Clarithromycin/administration & dosage/*adverse effects
MH  - Drug Therapy, Combination
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Mycobacterium avium Complex
MH  - *Mycobacterium avium-intracellulare Infection
MH  - Pneumonia, Bacterial/*drug therapy/*microbiology
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - Adverse effects
OT  - Azithromycin
OT  - Clarithromycin
OT  - Mycobacterium avium complex
COIS- Declaration of competing interest The authors have no conflict of interest.
EDAT- 2021/01/14 06:00
MHDA- 2021/08/21 06:00
CRDT- 2021/01/13 05:48
PHST- 2020/02/25 00:00 [received]
PHST- 2020/08/13 00:00 [revised]
PHST- 2020/09/05 00:00 [accepted]
PHST- 2021/01/14 06:00 [pubmed]
PHST- 2021/08/21 06:00 [medline]
PHST- 2021/01/13 05:48 [entrez]
AID - S2212-5345(20)30137-4 [pii]
AID - 10.1016/j.resinv.2020.09.010 [doi]
PST - ppublish
SO  - Respir Investig. 2021 Mar;59(2):212-217. doi: 10.1016/j.resinv.2020.09.010. Epub 
      2021 Jan 9.