Mycobacterium abscessus is the second most important pathogen in
pulmonary disease caused by
nontuberculous mycobacteria (NTM), following
Mycobacterium avium.
Mycobacterium abscessus is classified into three subspecies M. abscessus subsp. abscessus, M. abscessus subsp. massiliense, and M. abscessus subsp. bolletii.
Mycobacterium abscessus is the most difficult to treat NTM due to its resistance to many
antibiotics.
Treatment should include an initial regimen of 2–3
injectable and oral
antibiotics for several weeks or months, followed by inhaled
amikacin and 1–3 oral
antibiotics, depending on the subspecies and
drug susceptibility patterns, including
macrolide susceptibility. The continuation phase should be continued for a minimum of 12 months after
culture conversion. Suitable
injectable antibiotics include
amikacin,
imipenem,
cefoxitin, and
tigecycline, while oral
antibiotics include
macrolides (
azithromycin or
clarithromycin),
clofazimine,
linezolid, and
moxifloxacin.
Surgery can be a useful adjunctive
therapy for some
patients with refractory
disease. However, the overall
treatment prognosis is still unsatisfactory. Therefore, novel and more effective interventions are required for the
treatment of M. abscessus
pulmonary disease.