From the Guidelines
Mycobacterium gordonae infections typically don't require treatment as this organism is usually a non-pathogenic environmental mycobacterium that rarely causes disease in humans. When treatment is necessary for confirmed pathogenic infections, a combination of antibiotics is used, generally including clarithromycin, ethambutol, rifabutin, linezolid, and the fluoroquinolones as they have been found to be most consistently active in vitro against M. gordonae 1. The choice of antibiotics should be guided by susceptibility testing whenever possible, as resistance patterns can vary. Treatment duration is typically prolonged, but there is limited data available on the optimal duration of treatment for M. gordonae infections. Regular monitoring of liver function is important during treatment due to the potential hepatotoxicity of some antimycobacterial medications. Some key points to consider in the treatment of M. gordonae infections include:
- The use of antimicrobial agents that are active against M. gordonae, such as ethambutol, rifabutin, clarithromycin, linezolid, and the fluoroquinolones 1
- The importance of susceptibility testing to guide antibiotic choices
- The potential need for prolonged treatment duration
- The importance of monitoring liver function during treatment
- The consideration of surgical intervention for localized infections, such as skin lesions or abscesses.
From the Research
Treatment for Mycobacterium gordonae Infections
The treatment for Mycobacterium gordonae infections typically involves anti-mycobacterial therapy. Some key points to consider include:
- The use of multi-antimicrobial combination therapy, as seen in a study where patients were cured after treatment with a combination of drugs 2.
- The importance of adequate source control, as noted in the same study 2.
- The potential effectiveness of clarithromycin, either alone or in combination with other drugs, as reported in several studies 3, 4.
- The use of other antibiotics, such as azithromycin, rifampin, and ciprofloxacin, as seen in a case report where a patient was treated with a multidrug regimen 5.
- The potential for treatment with rifampin and ethambutol, as reported in a case of a young, immunocompetent patient with pulmonary Mycobacterium gordonae infection 6.
Treatment Options
Some specific treatment options for Mycobacterium gordonae infections include:
- Clarithromycin, which has been shown to be effective in several cases 3, 4.
- A combination of clarithromycin and sparfloxacin, which was effective in eradicating M. gordonae from a patient's sputum 3.
- A multidrug regimen of azithromycin, rifampin, and ciprofloxacin, which was effective in treating a patient with disseminated M. gordonae infection 5.
- A short course of rifampin and ethambutol, which resulted in clinical and radiographic improvement in a patient with pulmonary M. gordonae infection 6.
Key Considerations
Some key considerations when treating Mycobacterium gordonae infections include:
- The importance of drug susceptibility testing to guide treatment decisions, as noted in several studies 5, 3.
- The potential for M. gordonae to be pathogenic in both immunocompromised and immunocompetent hosts, as reported in several studies 2, 5, 6.
- The need for further studies to understand the pathogenesis of M. gordonae infection in humans, as noted in a case report 5.