{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T02:34:26Z","timestamp":1790044466492,"version":"4.0.1"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2014,1,1]],"date-time":"2014-01-01T00:00:00Z","timestamp":1388534400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>Treatment of pulmonary nontuberculous mycobacteria, especially Mycobacterium abscessus, requires prolonged, multidrug regimens with high toxicity and suboptimal efficacy. Options for refractory disease are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We reviewed the efficacy and toxicity of inhaled amikacin in patients with treatment-refractory nontuberculous mycobacterial lung disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Records were queried to identify patients who had inhaled amikacin added to failing regimens. Lower airway microbiology, symptoms, and computed tomography scan changes were assessed together with reported toxicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>The majority (80%) of the 20 patients who met entry criteria were women; all had bronchiectasis, two had cystic fibrosis and one had primary ciliary dyskinesia. At initiation of inhaled amikacin, 15 were culture positive for M. abscessus and 5 for Mycobacterium avium complex and had received a median (range) of 60 (6, 190) months of mycobacterial treatment. Patients were followed for a median of 19 (1, 50) months. Eight (40%) patients had at least one negative culture and 5 (25%) had persistently negative cultures. A decrease in smear quantity was noted in 9 of 20 (45%) and in mycobacterial culture growth for 10 of 19 (53%). Symptom scores improved in nine (45%), were unchanged in seven (35%), and worsened in four (20%). Improvement on computed tomography scans was noted in 6 (30%), unchanged in 3 (15%), and worsened in 11 (55%). Seven (35%) stopped amikacin due to: ototoxicity in two (10%), hemoptysis in two (10%), and nephrotoxicity, persistent dysphonia, and vertigo in one each.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In some patients with treatment-refractory pulmonary nontuberculous mycobacterial disease, the addition of inhaled amikacin was associated with microbiologic and\/or symptomatic improvement; however, toxicity was common. Prospective evaluation of inhaled amikacin for mycobacterial disease is warranted.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1513\/annalsats.201307-231oc","type":"journal-article","created":{"date-parts":[[2014,2,14]],"date-time":"2014-02-14T10:04:54Z","timestamp":1392372294000},"page":"30-35","source":"Crossref","is-referenced-by-count":161,"title":["Inhaled Amikacin for Treatment of Refractory Pulmonary Nontuberculous Mycobacterial Disease"],"prefix":"10.1093","volume":"11","author":[{"given":"Kenneth N.","family":"Olivier","sequence":"first","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela A.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Biostatistics Research Branch, National Institute of Allergy and Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tanya S.","family":"Glaser","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darshana","family":"Bhattacharyya","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michelle","family":"Fleshner","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen C.","family":"Brewer","sequence":"additional","affiliation":[{"name":"Otolaryngology Branch, National Institute of Deafness and Other Communication Disorders"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher K.","family":"Zalewski","sequence":"additional","affiliation":[{"name":"Otolaryngology Branch, National Institute of Deafness and Other Communication Disorders"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Les R.","family":"Folio","sequence":"additional","affiliation":[{"name":"Department of Radiology and Imaging Sciences; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jenifer R.","family":"Siegelman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shamira","family":"Shallom","sequence":"additional","affiliation":[{"name":"Microbiology Service, Department of Laboratory Medicine, Clinical Center; National Institutes of Health, Bethesda, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In Kwon","family":"Park","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth P.","family":"Sampaio","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrian M.","family":"Zelazny","sequence":"additional","affiliation":[{"name":"Microbiology Service, Department of Laboratory Medicine, Clinical Center; National Institutes of Health, Bethesda, Maryland; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven M.","family":"Holland","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Infectious Diseases"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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