Dual β-lactam for treatment of pulmonary Mycobacterium abscessus in a child

Antimicrob Agents Chemother. 2024 May 17:e0031924. doi: 10.1128/aac.00319-24. Online ahead of print.

Abstract

Treatment of Mycobacterium abscessus infection presents significant challenges, exacerbated by the emergence of macrolide-resistant strains that necessitate the use of multiple antimicrobials in combination and carry the potential for significant toxic effects. Select dual beta-lactam combinations, with or without beta-lactamase inhibitors, have been shown to be highly active in vitro. Herein, we describe a 6-year-old child with underlying mild bilateral lower lobe cylindrical bronchiectatic lung disease who developed pulmonary Mycobacterium abscessus infection and was treated with a multi-drug regimen including two β-lactam antibiotics, achieving both early clinical and microbiological cure. This case highlights the potential benefit of dual β-lactam therapy for the treatment of drug-resistant Mycobacterium abscessus infection.

Keywords: Mycobacterium abscessus; carbapenem; cephalosporin; dual β-lactams; pulmonary.