Aerosolized amikacin in patients with difficult-to-treat pulmonary nontuberculous mycobacteriosis.

Safdar A.

Eur J Clin Microbiol Infect Dis. 2012 Aug;31(8):1883-7.

Patients with pulmonary nontuberculous mycobacteriosis (pNTM) may have suboptimum response to conventional antimicrobial therapy. Aerosolized amikacin (aeAmk) was  given to nine patients who had failed standard combination oral antimycobacterial drugs. A favorable toxicity profile, even in patients given aeAmk for an extended duration, median 75 ± 85 (range, 18-277) days and total cumulative dose 35,400 ±  30,568 (range, 7,600-95,400) mg, was encouraging, as was the clinical response and resolution of symptoms in 8 of 9 patients. The patient who failed therapy died due to complications arising from prior hematopoietic transplantation. The feasibility and efficacy of aeAmk in combination with oral anti-NTM drug(s) for
treatment-refractory disease and, importantly, in primary therapy for pNTM requires validation randomized trials.