Inhaled Amikacin-Containing Multidrug Regimens for Resistant Bacteria

Shot of a man coughing while recovering from an illness on the sofa at home
Investigators assessed outcomes following treatment with inhaled amikacin with or without clofazimine among patients with Mycobacterium abscessus pulmonary disease.

Treatment with inhaled amikacin-containing multidrug regimens was found to improve Mycobacterium abscessus subspecies massiliense pulmonary disease, according to the results of a recent study published in CHEST.

Treatment-naive patients with M abscessus pulmonary disease were prospectively treated with multidrug regimens containing inhaled amikacin with or without clofazimine. Patients then underwent treatment with intravenous amikacin, imipenem (or cefoxitin), and oral azithromycin. Oral clofazimine was added for patients with M abscessus subspecies abscessus or M abscessus subspecies massiliense with cavitary lesions. Outcomes were assessed 1 year following treatment initiation.

Among the 82 treatment-naive patients with M abscessus pulmonary disease, M massiliense subspecies was identified in 46 (56%) and M abscessus subspecies was identified in 36 (44%). One year after treatment initiation, 53 (65%) patients were determined to have achieved cure: 42 of 46 patients (91%) with the M massiliense subspecies and 11 of 36 patients (31%) with the M abscessus subspecies.

The study authors wrote, “Inhaled amikacin with or without clofazimine in the regimen provides favorable treatment outcomes in M massiliense [pulmonary disease].” They added, “However, more effective treatments are needed for M abscessus [pulmonary disease].”


Kang N, Jeon K, Kim H, et al. Outcomes of inhaled amikacin-containing multidrug regimens for Mycobacterium abscessus pulmonary disease. 2021;160(2):436-445. doi:10.1016/j.chest.2021.02.025