Management of Drug Toxicity in Mycobacterium avium Complex Pulmonary Disease: An Expert Panel Survey

Jakko van Ingen; Stefano Aliberti; Claire Andrejak; James D Chalmers; Luigi R Codecasa; Charles L Daley; Naoki Hasegawa; David E Griffith; Wouter Hoefsloot; Gwen Huitt; Julie Jarand; Byung Woo Jhun; Michael R Loebinger; Theodore K Marras; Kozo Morimoto; Eva Polverino; Felix C Ringshausen; Miguel Santin; Rachel Thomson; Dirk Wagner; Richard J Wallace; Kevin L Winthrop; Jae-Joon Yim

doi:10.1093/cid/ciaa1361

Management of Drug Toxicity in Mycobacterium avium Complex Pulmonary Disease: An Expert Panel Survey

Clin Infect Dis. 2021 Jul 1;73(1):e256-e259. doi: 10.1093/cid/ciaa1361.

Authors

Jakko van Ingen¹, Stefano Aliberti^{2

3}, Claire Andrejak⁴, James D Chalmers⁵, Luigi R Codecasa⁶, Charles L Daley⁷, Naoki Hasegawa⁸, David E Griffith⁹, Wouter Hoefsloot¹⁰, Gwen Huitt⁷, Julie Jarand¹¹, Byung Woo Jhun¹², Michael R Loebinger^{13

14}, Theodore K Marras¹⁵, Kozo Morimoto¹⁶, Eva Polverino¹⁷, Felix C Ringshausen¹⁸, Miguel Santin¹⁹, Rachel Thomson²⁰, Dirk Wagner²¹, Richard J Wallace²², Kevin L Winthrop²³, Jae-Joon Yim²⁴

Affiliations

¹ Center for Infectious Diseases, Department of Medical Microbiology, Radboud University Medical Center, Nijmegen, The Netherlands.
² University of Milan, Department of Pathophysiology and Transplantation, Milan, Italy.
³ Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Ca' Granda Ospedale Maggiore Policlinico, Respiratory Unit and Cystic Fibrosis Adult Center, Milan, Italy.
⁴ Department of Pneumology, University Hospital of Amiens-Picardie, Amiens, France.
⁵ Division of Molecular and Clinical Medicine, University of Dundee, Dundee, United Kingdom.
⁶ Regional Tuberculosis Reference Centre, Villa Marelli Institute-Niguarda Hospital, Milan, Italy.
⁷ Division of Mycobacterial and Respiratory Infections, National Jewish Health and University of Colorado, Denver, Colorado, USA.
⁸ Department of Infectious Diseases, Keio University School of Medicine, Tokyo, Japan.
⁹ Department of Medicine, University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
¹⁰ Center for Infectious Diseases, Department of Pulmonology, Radboud University Medical Center, Nijmegen, The Netherlands.
¹¹ Division of Respiratory Medicine, Department of Medicine, University of Calgary, Calgary, Canada.
¹² Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
¹³ Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust, London, United Kingdom.
¹⁴ National Heart and Lung Institute, Imperial College, London, United Kingdom.
¹⁵ Departments of Medicine at the Toronto Western Hospital/University Health Network and the University of Toronto, Toronto, Canada.
¹⁶ Respiratory Disease Center, Fukujuji Hospital, Anti-Tuberculosis Association, Tokyo, Japan.
¹⁷ Servei de Pneumologia, Hospital Universitari Vall d'Hebron, Institut de Recerca Vall d'Hebron, Barcelona, Spain.
¹⁸ Department of Respiratory Medicine, Hannover Medical School and Biomedical Research in Endstage and Obstructive Lung Disease Hannover, German Center for Lung Research, Hannover, Germany.
¹⁹ Service of Infectious Diseases, Bellvitge University Hospital, University of Barcelona, Hospitalet de Llobregat, Barcelona, Spain.
²⁰ Gallipoli Medical Research Institute, University of Queensland, Brisbane, Australia.
²¹ Division of Infectious Diseases, Department of Medicine II, Medical Center-University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
²² Mycobacteria/Nocardia Research Laboratory, University of Texas Health Science Center at Tyler, Tyler, Texas, USA.
²³ Oregon Health and Science University, Portland, Oregon, USA.
²⁴ Division of Pulmonary and Critical Care Medicine, Seoul National University College of Medicine, Seoul, South Korea.

Abstract

Adverse events are frequent in nontuberculous mycobacteria pulmonary disease treatment, but evidence to support their management is scarce. An expert panel survey on management of adverse events shows consistent opinions on management of hepatoxicity, ocular toxicity, ototoxicity, tinnitus, and gastrointestinal upset. These opinions can provide assistance in individual patient management decisions.

Keywords: Mycobacterium avium complex; adverse events; antibiotic treatment; azithromycin; nontuberculous mycobacteria.

MeSH terms

Drug-Related Side Effects and Adverse Reactions*
Humans
Lung Diseases* / chemically induced
Mycobacterium Infections, Nontuberculous*
Mycobacterium avium Complex
Mycobacterium avium-intracellulare Infection* / drug therapy
Nontuberculous Mycobacteria