Clinical Epidemiology and Ageing

Reduced risk of nontuberculous mycobacteria in cystic fibrosis adults receiving long-term azithromycin.

Coolen N, Morand P, Martin C, Hubert D, Kanaan R, Chapron J, Honoré I, Dusser D, Audureau E, Veziris N, Burgel P-R J Cyst Fibros. 2015;14(5):594-9.

<p><b>BACKGROUND: </b>Azithromycin reduces exacerbations in cystic fibrosis (CF) patients. Our aim was to investigate its association with nontuberculous mycobacteria isolation and macrolide susceptibility.</p><p><b>METHODS: </b>From 2006 to 2010, all adult CF subjects at Cochin Hospital (Paris, France) harboring at least one positive NTM isolate were identified (Cases). In a nested case-control study, each Case was individually matched for age and gender with up to 4 CF adults with no NTM isolate (Controls). Clinical data at the time of first NTM isolate (index date) in Cases were compared with those of Controls using multivariate conditional regression analysis.</p><p><b>RESULTS: </b>CF subjects with positive NTM isolates (Cases, n=41) were matched to 155 Controls. Among Cases, 48.7% had isolates from Mycobacterium avium complex and 58.5% from Mycobacterium abscessus complex, and 31 Cases fulfilled the 2007 American Thoracic Society criteria for NTM infection (ATS+ Cases). Cases and ATS+ Cases were more likely to have low body mass index and colonization with Aspergillus fumigatus. Azithromycin was associated with a two-fold reduction in NTM isolates. Only one M. avium complex isolate had acquired macrolide resistance.</p><p><b>CONCLUSION: </b>These data suggest that azithromycin is a primary prophylaxis for NTM infection in CF adults.</p>

MeSH terms: Adult; Anti-Bacterial Agents; Azithromycin; Cystic Fibrosis; Female; Follow-Up Studies; Humans; Male; Mycobacterium Infections, Nontuberculous; Nontuberculous Mycobacteria; Retrospective Studies; Time Factors; Treatment Outcome; Young Adult
DOI: 10.1016/j.jcf.2015.02.006