Combined administration of rifampicin, ethambutol, and clarithromycin for the treatment of tenosynovitis of the hand caused by Mycobacterium avium complex: Case series and literature review.
Aged
Anti-Bacterial Agents
/ administration & dosage
Clarithromycin
/ administration & dosage
Drug Therapy, Combination
Ethambutol
/ administration & dosage
Female
Hand
/ microbiology
Humans
Male
Middle Aged
Mycobacterium avium Complex
Mycobacterium avium-intracellulare Infection
/ drug therapy
Rifampin
/ administration & dosage
Tenosynovitis
/ drug therapy
Journal
Medicine
ISSN: 1536-5964
Titre abrégé: Medicine (Baltimore)
Pays: United States
ID NLM: 2985248R
Informations de publication
Date de publication:
30 Apr 2021
30 Apr 2021
Historique:
received:
13
11
2020
accepted:
08
03
2021
entrez:
28
4
2021
pubmed:
29
4
2021
medline:
5
5
2021
Statut:
ppublish
Résumé
We report the clinical results and problems of combined administration of rifampicin, ethambutol, and clarithromycin (REC) for the treatment of Mycobacterium avium complex (MAC) infection of the hand (hand MAC).Participants included 7 patients with hand MAC. After resection of the infected lesion, REC was prescribed for 12 months. For these patients, the site of infection, clinical course after initiation of REC, adverse drug effects (ADEs), and incidence of recurrence were evaluated.Sites of infection were the flexor tenosynovium in 5 patients, extensor tenosynovium in 1 patient, and both flexor and extensor tenosynovium in 1 patient. ADEs of REC occurred in 5 patients, and included visual disturbance caused by ethambutol in 2 patients, liver function abnormality caused by rifampicin in 2 patients, and fever with diarrhea caused by rifampicin in 1 patient. For 2 of these 5 patients, desensitization therapy was applied and REC was able to be reinstated. In the remaining 3 patients, the causative drugs were discontinued and levofloxacin, a new quinolone, was administered. Complete healing was achieved in 5 patients, and recurrence was observed in 2 patients. These 2 patients with recurrence included 1 patient in whom REC was completed and 1 patient in whom REC therapy was modified due to ADE.REC provided relatively good clinical results as a treatment for hand MAC. However, recurrences were observed even after the completion of REC and the use of an alternative drug. Optimal duration of REC and appropriate alternative drugs need to be identified in the future.
Identifiants
pubmed: 33907090
doi: 10.1097/MD.0000000000025283
pii: 00005792-202104300-00005
pmc: PMC8084042
doi:
Substances chimiques
Anti-Bacterial Agents
0
Ethambutol
8G167061QZ
Clarithromycin
H1250JIK0A
Rifampin
VJT6J7R4TR
Types de publication
Case Reports
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
e25283Informations de copyright
Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.
Déclaration de conflit d'intérêts
The authors have no conflicts of interest to disclose.
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