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The recent discovery that rifabutin is active against <jats:italic>M. abscessus<\/jats:italic> has raised interest in using rifabutin to treat this intractable disease. In this study, we evaluated the in vitro activity of rifabutin against 194\u2009<jats:italic>M. abscessus<\/jats:italic> clinical isolates collected during 2012 January to 2017 December. As expected, rifabutin demonstrated considerably lower MICs against <jats:italic>M. abscessus<\/jats:italic>, with an MIC<jats:sub>50<\/jats:sub> of 2\u2009\u03bcg\/mL and MIC<jats:sub>90<\/jats:sub> of 4\u2009\u03bcg\/mL, respectively. Notably, the anti\u2010<jats:italic>M.abscessus<\/jats:italic> activity was even stronger among clarithromycin\u2010insusceptible strains. In addition, <jats:italic>M. abscessus<\/jats:italic> isolates with a rough morphotype were more sensitive to rifabutin compared with those forming smooth colonies when considered as a whole or in separate subspecies. Results from synergistic experiments revealed that the in vitro activity of rifabutin was significantly enhanced by the addition of amikacin, suggesting a promising strategy for <jats:italic>M. abscessus<\/jats:italic> infection combination treatment. Finally, five and three mutation patterns in <jats:italic>rpoB<\/jats:italic> and <jats:italic>arr<\/jats:italic>, respectively, were identified among the 194 strains through whole genome sequencing. However, none of them conferred rifabutin resistance. Our study is among the first to report the susceptibility of <jats:italic>M. abscessus<\/jats:italic> to rifabutin <jats:italic>in vitro<\/jats:italic> with a large amount of clinical isolates, suggesting that rifabutin is active, both alone and in combination, against <jats:italic>M. abscessus<\/jats:italic> and is worth considering as part of a combination treatment regimen for <jats:italic>M. abscessus<\/jats:italic> infections.<\/jats:p>","DOI":"10.1111\/1440-1681.13651","type":"journal-article","created":{"date-parts":[[2022,5,9]],"date-time":"2022-05-09T08:44:38Z","timestamp":1652085878000},"page":"767-775","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["In vitro activity of rifabutin against <i>Mycobacterium abscessus<\/i>, clinical isolates"],"prefix":"10.1111","volume":"49","author":[{"given":"Jianhui","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Respiratory and Critical Care 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