10
Treatment
Table 5. Treatment Regimens for Mycobacterium abscessus
by Macrolide Susceptibility (Mutational and
Inducible Resistance)
Macrolide
Susceptibility Pattern
No. of
Drugs
c
Preferred Drugs
Frequency of
Dosing Mutational
a
Inducible
b
Susceptible Susceptible Initial phase
≥3
Parenteral
(choose 1–2)
Amikacin
Imipenem
(or Cefoxitin)
Tigecycline
Oral (choose 2)
Azithromycin
(clarithromycin)
d
Clofazimine
Linezolid
Daily (3 times
weekly may
be used for IV
aminoglycosides)
Continuation
phase ≥2
Oral/inhaled
(choose 2–3)
Azithromycin
(clarithromycin)
d
Clofazimine
Linezolid
Inhaled amikacin
Susceptible Resistant Initial phase
≥4
Parenteral
(choose 2–3)
Amikacin
Imipenem (or
Cefoxitin)
Tigecycline
Oral (choose 2–3)
Azithromycin
(clarithromycin)
e
Clofazimine
Linezolid
Daily (3 times
weekly may
be used for IV
aminoglycosides)
Table 4. Treatment Regimens for Mycobacterium abscessus
Antimicrobial Agents
MIC, μg/mL
Comments S I R
First Line
Clarithromycin ≤8 16 ≥32 (3) Clarithromycin is the class
drug for macrolides and the only
macrolide that needs to be tested.
Amikacin (IV) ≤16 32 ≥64
Amikacin (liposomal,
inhaled)
≤64 – ≥128
