Relationship between Resistance to Ethambutol and Rifampin and Clinical Outcomes in Mycobacterium avium Complex Pulmonary Disease

Antimicrob Agents Chemother. 2022 Apr 19;66(4):e0202721. doi: 10.1128/aac.02027-21. Epub 2022 Mar 10.

Abstract

We evaluated the associations between the in vitro activities of ethambutol and rifampin and clinical outcomes of Mycobacterium avium complex (MAC) pulmonary disease (PD). Among 158 patients with MAC-PD, there was no relationship between high MICs for ethambutol and/or rifampin and treatment failure for MAC-PD. Ethambutol and rifampin resistance was common among MAC isolates (rates of 87% and 59%, respectively), but mutations in embB, rpoB, and rpoC were rare, with detection in only 4% of the drug-resistant MAC isolates.

Keywords: MIC; Mycobacterium avium complex; ethambutol; outcome; rifampin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Antitubercular Agents / pharmacology
  • Antitubercular Agents / therapeutic use
  • Drug Therapy, Combination
  • Ethambutol / pharmacology
  • Ethambutol / therapeutic use
  • Humans
  • Lung Diseases* / drug therapy
  • Lung Diseases* / microbiology
  • Mycobacterium avium Complex / genetics
  • Mycobacterium avium-intracellulare Infection* / drug therapy
  • Mycobacterium avium-intracellulare Infection* / microbiology
  • Rifampin / pharmacology
  • Rifampin / therapeutic use

Substances

  • Anti-Bacterial Agents
  • Antitubercular Agents
  • Ethambutol
  • Rifampin