TY - T1的失败与获得性耐药an optimised bedaquiline-based treatment regimen for pulmonary Mycobacterium avium complex disease JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00118-2019 VL - 54 IS - 1 SP - 1900118 AU - Zweijpfenning, Sanne M.H. AU - Schildkraut, Jodie A. AU - Coolen, Jordy P.M. AU - Ruesen, Carolien AU - Koenraad, Ellen AU - Janssen, Anne AU - Ruth, Mike M. AU - de Jong, Arjan S. AU - Kuipers, Saskia AU - Aarnoutse, Rob E. AU - Magis-Escurra, Cecile AU - Hoefsloot, Wouter AU - van Ingen, Jakko Y1 - 2019/07/01 UR - //www.qdcxjkg.com/content/54/1/1900118.abstract N2 - 5 years ago, a then 50-year-old woman presented with long-standing fatigue, dyspnoea and a chronic productive cough. Based on a computed tomography scan of the thorax and multiple positive cultures, she was diagnosed with nodular–bronchiectatic Mycobacterium avium pulmonary disease; she was also found to have a heterozygous F508del CFTR gene mutation. She commenced therapy with rifabutin 300 mg once daily, ethambutol 1200 mg once daily and azithromycin 500 mg once daily. After 15 months of ongoing symptoms, radiographic deterioration and persistent culture positivity, clofazimine 100 mg once daily and thrice weekly intravenous amikacin 15 mg·kg−1 were added to the regimen. Amikacin was halted after 4 months; the remaining four drugs were continued. The dose of azithromycin was lowered to 250 mg once daily after 9 months because of hearing loss.In its current dose, bedaquiline is probably not a viable treatment option for treatment-refractory MAC-PD; even with adequate exposure, treatment fails due to acquired resistance documented by increasing MICs and whole-genome sequencing http://bit.ly/2YvaTMM ER -