Clinical effect of combined chemotherapy according to guidelines fro the treatment of pulmonary Mtcobacterium complex disease, including a follow-up study

Purpose: To investigate the clinical effect of combined chemotherapy according to the guideline for pulmonary Mycobacterium acium complex (MAC) disease and conduct a follow-up study after the completion of treatment. Materials and Methods: The subjects consisted of 105 patients with pulmonary MAC disease who received combined chemotherapy accroding to the guideline for over one year and follow-up after the completion of treatment between 2008 and 2017. We analyzed the microbiological effect and the clinical effect of these patients. Results: The average age of the 105 patients was 69.2 years old. Sixty-nine patients had underlying diseases, including 10 patients receiving immunosuppressivc treatments. The microbiological findings were smear-positive for acid-fast bacilli in 73 patients and the resistant isolate for CAM was isolated in one patient. The causative microorganisms were M.avium in 47 patients and M.intracellulare in 51. Concerning the treatment, the sputum conversion rate was 87% and the clinical effect was a good response in 69%. Athough the clinical course of patients who showed a good response and continued the same treatment was stable, that of patients who stopped the treatment (40%) worsened again within several years after the completion of treatment. Conclusions: Because most patients were receiving thir first course of treatment for pulmonary MAC disease, the clinical effect of combined chemotherapy accrording to the guideline was good over the last ten years. However, the relapse rate was high within several years. Therefore, we have to conduct long-term follow-up after the completion of treatment.