Efficacy of clofazimine-containing regimens for treatment of Mycobacterium avium complex–pulmonary disease in patients unsuitable for standard treatment regimen

氯法齐明 文化转换 医学 养生 分枝杆菌复合群 痰培养 外科 肺结核 内科学 麻风病 免疫学 病理
作者
Shengjuan Bao,Suting Chen,Jifang Zheng,J. Ma,Jiali Yang,Hairong Huang,Hongfei Duan
出处
期刊:International Journal of Antimicrobial Agents [Elsevier BV]
卷期号:63 (2): 107061-107061 被引量:1
标识
DOI:10.1016/j.ijantimicag.2023.107061
摘要

: Patients with Mycobacterium avium complex-pulmonary disease (MAC-PD) can exhibit contraindications in applying the recommended treatment regimens by the guidelines. Clofazimine (CFZ) is considered a promising drug for MAC-PD treatment and is frequently included in alternative regimens; however, its efficacy remains unclear. : MAC-PD patients, unsuitable for standard regimens, were enrolled continuously in a prospective study at Beijing Chest Hospital. The treatment response of the CFZ-containing regimen was monitored. : Fifty patients were enrolled in the initial treatment, and 25 patients had a history of anti-TB treatment. Nodular bronchiectasis was observed in 34 patients, while 8 patients exhibited fibrocavitary changes. Additionally, 8 patients displayed a combination of both patterns. In a multivariate analysis, MAC-PD patients with CFZ MIC< 0.25 mg/L were significantly associated with culture conversion [OR 8.415, 95% CI (1.983-35.705); P =0.004]. Among patients who had previous TB treatment history, patients with CFZ MIC < 0.25 mg/L had a higher chance of acquiring culture conversion outcomes [(OR 7.737, 95% CI 1.032-57.989); P =0.046]. In contrast, among patients with no previous TB treatment history, the RIF-containing regimen had a higher chance of acquiring culture conversion outcomes [(OR 11.038, 95%CI 1.008-120.888); P = 0.049]. : MAC-PD patients unsuitable for standard regimens could benefit from a CFZ-containing regimen, especially for patients with previous TB treatment history and baseline CFZ MIC values lower than 0.25 mg/L.
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