Mycobacterium abscessus is one of the hardest to treat non-TB mycobacteria due to antimicrobial resistance, side effects of therapy, and patient comorbidities. It is even harder to treat in certain patient populations such as people with cystic fibrosis. I am interested in YOUR EXPERIENCES in treating M.abscessus especially in CF patients. Any adjuvant therapies, synergestic antimicrobial combinations, or specific measures taken, especially in early disease where there is no focal areas to consider surgical resection. P.S treatment guidelines attached
Encourage the patient to comply with the prescription and the patient should be adequately monitored. Encourage the patient to eat food that will boost his immune level.
Very challenging infection to treat.
I would recommend longer IV therapy (then what the guideline states) if patient can tolerate it.
Inhaled liposomal amikacin (after IV antibiotic phase) - if you can enroll your patient in compassionate use protocol. (http://www.insmed.com/clinical-trials/)
Also there is an updated guidelines on management of NTM in the CF population. Here is the link :http://thorax.bmj.com/content/71/Suppl_1/i1.long
Thank you Hari.
the main problem I'm facing is that I do not have much of options on drug sensitivity testing. An old micro from a different lab. It is S to amikacin but I do not have the MIC.
So, my Cmax amikacin target is being around 60: based on a Korean study.
imipenem is R cefoxitin is I.
Any experience with addicting avibactam For synergy?