Investigation of drug regimens and treatment outcome in patients with Mycobacterium Simiae: a systematic review

ABSTRACT

Introduction

Mycobacterium simiae (M.simiae), a non-tuberculous mycobacterium (NTM), rare causes infection including localized pulmonary to disseminated disease in immunocompromised patients. An optimal pharmacological management practice has not yet been defined for this infection. This study investigates drug regimens and treatment outcomes in patients with M. simiae to describe different drug regimen with the therapeutic response.

Areas covered

The three databases PubMed, Scopus, and Web of science were systematically searched from June 1994 to June 2021 to retrieve relevant articles. The inclusion criterion included studies, which reported treatment outcomes in patients with M. simiae infections. Treatment success was defined as the achievement of culture conversion, and the improvement of the symptoms and radiologic signs among the patients.

Expert opinion

Data of 223 patients were retrieved from 40 studies. Duration of the treatment regimens used in different studies ranged from 2 to 12 months. The most common treatment regimens administered for M. simiae infection were as follows: clarithromycin, rifampin, ethambutol, moxifloxacin, or ciprofloxacin and amikacin plus cotrimoxazole or pyrazinamide in some regimens. Macrolides, such as clarithromycin, combined with quinolones (such as moxifloxacin) and TMP/SMX, which are used in combination, had the most significant effect on eliminating the pulmonary signs of M. simiae.

KEYWORDS:

• Mycobacterium simiae
• NTM
• nontuberculous mycobacteria
• systematic review
• therapy
• outcome

Article highlights

• M. simiae is a rare cause of clinical disease, but twenty-one percent of M. simiae were isolated from patients with underlying disease.

• The optimal medication for M. simiae has yet to be defined and treatment for M. simiae has proven difficult.

• There is a lack of systematic review describing different drug regimens in M. simiae patients.

• Drug regimens combination based on clarithromycin should be used.

Author contributions

Sh Dashtbin conducted data and prepared manuscript. M Dadashi and Sh Mirkalantari helped in comprehensive research. D Darban-Sarokhalil designed and conducted the study and contributed in manuscript witting and editing.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.