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Levoxacin (Levaquin)
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Levoxacin

Levoxacin is used to treat bacterial infections in many different parts of the body. It is also used to prevent an anthrax infection after a person has been exposed to anthrax. This medicine is also used to treat and prevent plague (including pneumonic and septicemic plague).

Other names for this medication:
Cravit, Elequine, Farlev, Glevo, Leflox, Levaquin, Levobact, Levocin, Levoday, Levoflox, Levofloxacin, Levofloxacina, Levofloxacino, Levomac, Levomax, Levox, Levoxa, Levoxin, Levozine, Loxof, Novacilina, Proxime, Recamicina, Tavanic, Truxa, Ultraquin, Uniflox

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Also known as:  Levaquin.

Description

To reduce the development of drug-resistant bacteria and maintain the effectiveness of Levoxacin and other antibacterial drugs, Levoxacin should be used only to treat or prevent infections that are proven or strongly suspected to be caused by susceptible bacteria. When culture and susceptibility information are available, they should be considered in selecting or modifying antibacterial therapy. In the absence of such data, local epidemiology and susceptibility patterns may contribute to the empiric selection of therapy.

Levoxacin Tablets/Injection and Oral Solution are indicated for the treatment of adults (≥18 years of age) with mild, moderate, and severe infections caused by susceptible strains of the designated microorganisms in the conditions listed in this section. Levoxacin Injection is indicated when intravenous administration offers a route of administration advantageous to the patient (e.g., patient cannot tolerate an oral dosage form).

Dosage

Rapid or bolus intravenous infusion of Levoxacin has been associated with hypotension and must be avoided. Levoxacin Injection should be infused intravenously slowly over a period of not less than 60 or 90 minutes, depending on the dosage. Levoxacin Injection should be administered only by intravenous infusion. It is not for intramuscular, intrathecal, intraperitoneal, or subcutaneous administration.

Overdose

Overdose of the drug should be strictly avoided and if anyone has accidentally taken the overdose of the drug, then the victim should be provided with emergency medical help. Overdose victim can also consult to their local poison helpline. Some of the overdose symptoms include loss of coordination, drooping eyelids, weakness, decreased activity, trouble breathing, sweating, tremors, or seizure.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep in a tightly closed container. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Levoxacin are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Risk of tendinitis and tendon rupture is increased. This risk is further increased in older patients usually over 60 years of age, in patients taking corticosteroids, and in patients with kidney, heart and lung transplants. Discontinue if pain or inflammation in a tendon occurs.

Anaphylactic reactions and allergic skin reactions, serious, occasionally fatal, may occur after first dose.

Hematologic (including agranulocytosis, thrombocytopenia), and renal toxicities may occur after multiple doses.

Hepatotoxicity: Severe, and sometimes fatal, hepatoxicity has been reported. Discontinue immediately if signs and symptoms of hepatitis occur.

Central nervous system effects, including convulsions, anxiety, confusion, depression, and insomnia may occur after the first dose. Use with caution in patients with known or suspected disorders that may predispose them to seizures or lower the seizure threshold.

Clostridium difficile-associated colitis: evaluate if diarrhea occurs.

Peripheral neuropathy: discontinue if symptoms occur in order to prevent irreversibility.

Prolongation of the QT interval and isolated cases of torsade de pointes have been reported. Avoid use in patients with known prolongation, those with hypokalemia, and with other drugs that prolong the QT interval.

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a total of 1,157 enterococcal strains isolated from various clinical specimens from January 2010 to December 2012 in the General Hospital of Ningxia Medical University were identified to species level with a VITEK-2 COMPACT fully automated microbiological system, and the antimicrobial susceptibility of Enterococcus species was determined using the Kirby-Bauer disc diffusion method. The multiple-drug resistant enterococcal isolates were screened from the clinical isolates of Enterococcus species from the burns department. The minimal inhibitory concentration (MIC) of Enterococcus species to the three fluoroquinolones, including ciprofloxacin, gatifloxacin and levofloxacin was determined with the agar dilution method, and the changes in the MIC of Enterococcus species to the three fluoroquinolones following reserpine treatment were evaluated. The β-lactam, aminoglycoside, tetracycline, macrolide, glycopeptide resistance genes and the efflux pump emeA genes were detected in the enterococcal isolates using a polymerase chain reaction (PCR) assay.

levoxacin antibiotic

An n-of-1 study was performed using 2 treatment and 2 nontreatment phases during an infection-free interval. Treatment arms consisted of 10-day courses of levofloxacin 500 mg daily. The evaluating investigator, caregiver, and patient were blind to treatment assignments. Measures included the Apathy Evaluation Scale (clinician and caregiver), Apathy Inventory (clinician and caregiver), Northwestern University Disability Scale, Disability Assessment for Dementia, and caregiver clinical global impression score.

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The 3 fluoroquinolones reviewed showed comparable clinical and microbiologic efficacy for the treatment of CAP. In general, the fluoroquinolones were well tolerated, although some differences have been reported, including higher rates of gastrointestinal and other adverse events for gatifloxacin and moxifloxacin. Gatifloxacin and moxifloxacin exhibited greater in vitro potency than levofloxacin against Streptococcus pneumoniae. However, levofloxacin achieved a higher serum drug concentration than the other agents, allowing similar attainment of pharmacokinetic and pharmacodynamic targets required for effective treatment.

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Extragodanal germ cell tumors (EGCT) are not common, especially among women. Although there is no evidence of relationship between this sort of tumor and HIV infection they can appear at the same time in a patient, because in both cases the maximum incidence occurs in patients in the same age group. We present the case of a 27 years old woman, poly-drug user, with a recently diagnosis of HIV infection, who was admitted to clinic because of infection and shortage of breath, and develops during her hospitalization diarrhoea, generalized tonic-clonic seizure and left hemiparesis. Complementary tests showed us diffuse interstitial pulmonary pattern, mediastinal mass with intrathoracic adenopathies, cerebral tumor and diffuse intestinal enlargement. The breath infection got better with a wide-ranging antibiotic treatment, which included cotrimoxazol and levofloxacin, but the brain tumor didńt get better with the antitoxoplasma treatment. The clinical presentation simulated in the beginning a disseminated lymphoma, in a HIV+ patient; nevertheless, after receiving the result of the biopsy of a supraclavicular adenopathy and a b-HCG, an extragodanal germ cell tumor was diagnosed. We haven't found any case of EGCT in young women infected with HIV in our bibliographical review (MEDLINE).

levoxacin 500 mg antibiotico

The objective of this study was to characterise the epidemiology of Clostridium difficile in Scotland by determining the distribution of PCR ribotypes and antimicrobial susceptibility in 1613 isolates collected from all healthboard areas of Scotland in the period November 2007-December 2009. Three PCR ribotypes predominated amongst the Scottish isolates of C. difficile; ribotype 106 (29.4%), ribotype 001 (22%) and ribotype 027 (12.6%) followed by the less prevalent ribotypes including 002, 015, 014, 078, 005, 023 and 020. The distribution of ribotypes varied between healthboard areas. Ribotype 106 or 001 was the predominant ribotype in 10 healthboard areas, while ribotype 027 was the predominant type in two neighbouring areas. Antimicrobial susceptibility testing of C. difficile isolates showed high frequencies of resistance to moxifloxacin, levofloxacin, erythromycin and cefotaxime in the epidemic C. difficile ribotypes 001, 027 and 106 compared to other less common ribotypes. Furthermore, reduced susceptibility to metronidazole was found only in the epidemic strains. These findings are compatible with the hypothesis that fluoroquinolones, macrolides and cephalosporins may play a role in the spread of C. difficile in Scotland (while the role of metronidazole needs further investigations), and highlights the role of antimicrobial stewardship in preventing and controlling C. difficile infection (CDI).

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Randomised controlled trials (RCTs) in children of either sex, comparing at least two antibiotics for CAP within hospital or ambulatory (outpatient) settings.

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A case-control study was conducted to identify the risk factors associated with levofloxacin-resistant Streptococcus pneumoniae (LRSP) colonization or infection. Twenty-seven case patients (patients with LRSP) were compared with 54 controls (patients with levofloxacin-susceptible S. pneumoniae). Risk factors that were significantly associated with LRSP colonization or infection, according to univariate analysis, included an older age (median age, 75 years for case patients versus 72.5 years for controls), residence in a nursing home (odds ratio [OR], 7.2), history of recent (OR, 4.6) and multiple (OR, 4.4) hospitalizations, prior exposure to fluoroquinolones (OR, 10.6) and beta-lactams (OR, 8.6), presence of chronic obstructive pulmonary disease (COPD; OR, 5.9), and nosocomial origin of the bacteria (OR, 5.7). Multivariate analysis showed that presence of COPD (OR, 10.3), nosocomial origin of the bacteria (OR, 16.2), residence in a nursing home (OR, 7.4), and exposure to fluoroquinolones (OR, 10.7) were independently associated with LRSP colonization or infection. Thus, a distinct group of patients with COPD is the reservoir of LRSP.

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This partially masked randomized placebo-controlled multinational clinical study to evaluate prospectively the prophylactic effect of intracameral cefuroxime injection and/or perioperative levofloxacin eyedrops on the incidence of endophthalmitis after phacoemulsification cataract surgery began in September 2003 and was terminated early in January 2006. The study used random allocation of patients in a 2 x 2 factorial design.

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Our results suggest that, when combined to a β-lactam, levofloxacin is associated with lower mortality than ofloxacin or ciprofloxacin in severe pneumococcal community-acquired pneumonia.

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No significant difference was observed between the 2 groups in the cumulative incidences of failure of prophylaxis (P = 0.21), clinically documented infections (P = 0.70), or non-relapse mortality within the first 100 days after transplantation (P = 0.42). With bacteremia, the rate of resistance to LVFX was 82% in the PB group and 100% in the LVFX group (P = 0.41). Also, no significant difference was found in overall survival between the 2 groups (P = 0.78).

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We report a severe case of Staphylococcus lugdunensis (S. lugdunensis) keratitis presenting as suppurative keratitis in a 77-year-old woman. The patient's chief complaint was eye pain and decreased visual acuity in her right eye. Suppurative keratitis with a severe corneal abscess was diagnosed by a slit-lamp ophthalmic examination. The causative organism was identified as S. lugdunensis by bacterial culture, using a corneal abrasion specimen. She was treated with an intravenous drip infusion of ceftazidime and instillation of gentamicin sulfate ophthalmic solution (six times daily) and ofloxacin ophthalmic ointment (once daily before bedtime) as empiric therapy. Her hospital course was complicated by a corneal perforation of her right eye. The antibiotic susceptibility for S. lugdunensis was sensitive, but with a slightly high MIC for antibiotics used in empiric therapy. The therapeutic drug was changed to levofloxacin ophthalmic solution. The corneal abscess left a scar after healing. Representative causative organisms of suppurative keratitis include Pseudomonas aeruginosa and Streptococcus pneumoniae, but care must be taken in cases involving rare causative organisms. Empiric therapy is necessary for rapidly progressing suppurative keratitis, but a detailed examination of the causative organism is important for therapeutic planning before empiric therapy.

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levoxacin 500 mg antibiotico 2017-09-01

To investigate the relationship between corticosteroid therapy and kinetic Myambutol 400 Mg Tablet changes in chest X-ray in five patients with severe acute respiratory syndrome (SARS).

levoxacin antibiotics 2015-04-12

This pilot study assesses the safety and efficacy of once-daily, oral Amorion 50 Mg levofloxacin monotherapy in Chinese patients with low-risk febrile neutropenia. In this prospective, single-arm, open-label, multicenter clinical trial, 46 adult Chinese patients with solid tumors and low-risk febrile neutropenia were included. Patients received oral levofloxacin monotherapy (500 mg orally/day) until day 12, followed by 7 days of follow-up (day 19). Body temperature was measured three times per day. On days 2, 3, 5-7, 9, 12, and 19, disease symptoms and vital signs were recorded, adverse drug reactions were assessed, and blood samples were collected to determine the whole-blood cell count and the absolute neutrophil count. Blood cultures and chest radiographs were performed simultaneously until negative results were found. Oral levofloxacin was effective and well tolerated in 97.6% of patients irrespective of the cancer type and cause of fever. Body temperature began to decline in 24.4, 68.3, and 90.2% of patients, respectively, at 12, 24, and 48 h after initiating levofloxacin therapy. On days 5 and 7, 95.1 and 97.6% of the patients had complete defervescence, respectively. The median time for absolute neutrophil count recovery to at least 1500/mm after initiation of treatment was 3 days. Only one patient reported mild diarrhea. This pilot study showed that oral levofloxacin quickly and effectively reduced fever, initiated neutrophil recovery, and was well tolerated in Chinese low-risk febrile neutropenic patients with solid tumors. Further study is needed to compare patient data of levofloxacin with the standard amoxicillin/ciprofloxacin protocol in this population for both safety and efficacy.

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Dalbavancin is a lipoglycopeptide antimicrobial agent with a potency significantly better than that of vancomycin when tested against staphylococci Azitrox Capsule and streptococci. These two pathogens are common causes of skin and skin structure infections (SSSIs), and dalbavancin has been approved for the treatment of moderate to severe SSSIs. This study generated susceptibility data for staphylococci and beta-hemolytic streptococci from 52 U.S. medical centers that locally tested dalbavancin, vancomycin, and other antimicrobial class representatives to assess the potency of dalbavancin and the overall contemporary activities of commonly prescribed agents. Locally generated data showed that oxacillin-resistant staphylococci (57.0% overall) had slightly higher dalbavancin MIC(90) values (0.19 microg/ml) than oxacillin-susceptible strains (0.125 microg/ml). This potency was 8- to 16-fold greater than that for vancomycin. beta-Hemolytic streptococci had MIC(90) values ranging between 98% against staphylococci. Erythromycin resistance was high for staphylococci (30.6 to 94.1%) with inducible clindamycin resistance rates of 26.0% and 55.0% for oxacillin-susceptible and -resistant Staphylococcus aureus, respectively. Beta-hemolytic streptococci had a 20.2% erythromycin resistance rate and a 60% inducible clindamycin resistance rate but were highly susceptible to other tested agents. Etest reading errors were apparent and skewed results towards slightly higher dalbavancin MICs, requiring further education on how to interpret Etest method results for this compound. Current disk diffusion breakpoint criteria for oxacillin susceptibility for S. aureus showed a very-major-error rate of 2.3% and only a 0.9% minor-error rate when cefoxitin was used to predict oxacillin susceptibility. Dalbavancin demonstrated excellent potency and activity (100% susceptibility at proposed breakpoints) against common causes of SSSI pathogens in this U.S. multicenter study sample.

levoxacin 250 mg cistite 2015-02-10

In this prospective, multicenter, open-label, randomized controlled trial, 77 Tab Novacef 500 patients with mild-to-moderate community-acquired pneumonia with aspiration factors were enrolled and randomly assigned to receive moxifloxacin or levofloxacin plus metronidazole. The primary efficacy variables were clinical outcomes in evaluable patients at a follow-up visit 7 to 14 days after the end of therapy.

levoxacin antibiotic 2015-04-12

In a high vancomycin MIC group in Taiwan, SCCmec III, spa type t037, was the predominant strain of MRSA identified. Patients with MRSA bacteremia in the ICU or who had prolonged hospitalization were more likely to be infected with S. Clavaseptin 50mg Tablets aureus strains with high vancomycin MICs. The mortality rate was higher among patients infected with these strains compared to patients infected with low MIC strains.

levoxacin 500 mg 2017-06-22

A 37-year-old man suffered epidemic keratoconjunctivitis in Azimed Medicine both eyes. Eleven days later, he developed a corneal ulcer in his left eye. Bacterial staining, culture, and antibiotics sensitivity test were performed from a corneal scrape.

levoxacin 250 mg 2015-12-19

To evaluate the dosing regimens of Polymox Drug levofloxacin.

levoxacin 500 mg english 2015-05-27

At this time in the USA there are no antimicrobials with specific indications for oral infections, and many of those currently used have limited efficacy against oral anaerobic strains. We tested the activity of azithromycin against a broad range of anaerobic oral pathogens and, at pH 8, found it to be effective against 98% of strains, including all fusobacteria and beta-lactamase-producing strains of Prevotella spp Ilosone 250 Mg . All strains of Eikenella corrodens were also susceptible to azithromycin but resistant to erythromycin, clindamycin, metronidazole and cefalexin. Other comparator agents were penicillin, amoxicillin/clavulanic acid, tetracycline, levofloxacin and ciprofloxacin. Minimum inhibitory concentrations obtained on agar adjusted to pH 8 were generally one dilution lower than those obtained on agar at pH 7.

levoxacin 250 mg compresse 2017-09-06

We compared the in vitro antibacterial activity of DV-7751a against gram-positive and -negative bacteria with those of quinolones currently available. MICs for 90% of the strains tested (MIC90s) against clinical isolates of methicillin-susceptible and -resistant Staphylococcus aureus and Staphylococcus epidermidis were 0.20, 0.39, 0.20, and 0.78 micrograms/ml, respectively. Moreover, MIC50s for DV-7751a against ofloxacin-resistant methicillin-resistant S. aureus were 4-, 8-, 16-, 32-, and 64-fold lower than those for tosufloxacin and sparfloxacin, levofloxacin, ofloxacin and fleroxacin, ciprofloxacin, and lomefloxacin, respectively. DV-7751a inhibited the growth of all strains of Streptococcus pneumoniae, Streptococcus pyogenes, and Peptostreptococcus spp. at 0.39, 0.39, and 0.78 micrograms/ml, respectively, and was 4- to > 16-fold more active against enterococci at the MIC90 level than the other quinolones tested. The activity of DV-7751a against Pseudomonas aeruginosa was roughly comparable to those of levofloxacin and sparfloxacin at the MIC90 level and was two- to fourfold less than that of ciprofloxacin. DV-7751a showed activity comparable to those of levofloxacin and ciprofloxacin against the other glucose-nonfermenting bacteria Haemophilus influenzae, Neisseria gonorrhoeae, and Moraxella catarrhalis (MIC90s of 0.025, 0.20, and 0.10 micrograms/ml, respectively). DV-7751a activity was not affected by medium, inoculum size, or the addition of human serum but was decreased under acidic conditions and in human urine, as were the other quinolones tested. Time-kill curve studies demonstrated the rapid Cefuroxime Axetil 500 Dosage bactericidal action of DV-7751a against S. aureus, S. pneumoniae, Escherichia coli, and P. aeruginosa. The frequency of spontaneous resistance to DV-7751a was less than or equal to those of the reference drugs. DV-7751a inhibited the supercoiling activity of DNA gyrases from S. aureus, E. coli, and P. aeruginosa at concentrations comparable to those of levofloxacin and sparfloxacin.

levoxacin 500 mg prezzo 2016-01-19

We documented 446 patients withLP, of which 175 were treated with levofloxacin, 177 with azithromycin and 58 with clarithromycin. No significant differences in time to defervescence [2(IQR 1-4) vs. 2(IQR 1-3) days; p=0.453], time to achieve clinical stability [3(2-5) vs. 3(2-5) days; p=0.486]), length of intravenous therapy [3(2-5.25) vs. 4(3-6) days; p=0.058] and length of hospital stay [7(5-10) vs. 6(5-9) days; p=0.088] were found between patients treated with levofloxacin and those treated with azithromycin. Patients treated with clarithromycin had longer iv antibiotic treatment [3(2-5.25) vs. 5(3-6.25) days; p=0.002] and longer hospital stay [7(5-10) vs. 9(7-14) days; p=0.043] compared with those treated with levofloxacin. The overall mortality was 4.3% (19). Neither univariate nor multivariate analysis showed a significant association of levofloxacin vs. azithromycin on mortality [4 Amoclan 625 Dose (2.3%) vs. 9(5.1%) deaths; p=0.164]. The results did not change after incorporation of the propensity score into the models.

levoxacin 500 mg antibiotico 2016-01-06

Resistance of 235 Haemophilus influenzae clinical isolates from Istanbul Medical Faculty Hospital, Turkey were determined against 19 antibiotics by disc diffusion method, and minimum inhibitory concentrations (MICs) of those found resistant to ampicillin, cefuroxim, chloramphenicol and meropenem were measured using E-test. Ampicillin-resistant isolates producing beta-lactamase as demonstrated by a nitrocefin assay were analyzed for the presence of TEM-1 and ROB-1 genes by PCR. Eleven percent of the isolates were resistant to ampicillin (10 µg/ml), of which 73% were beta-lactamase positive and carried TEM-1 gene, but none were positive for ROB-1 gene. All isolates susceptible to amoxicillin-clavulanate (20/10 µg/ml), azithromycin (15 µg/ml), aztreonam (30 µg/ml), cefotaxime (30 µg/ml), ceftriaxone (30 µg/ml), ciprofloxacin (5 µg/ml), levofloxacin (5 µg/ml), and telithromycin (15 µg/ml) but 24%, 15%, 4%, 4%, 2%, 1%, 1%, 0.5%, 0.5% and 0.5% were resistant to trimethoprim-sulfamethoxazole (1.25/23.75 µg Floxin Drops Cost /ml), tetracycline (30 µg/ml), cefaclor (30 µg/ml), clarithromycin (15 µg/ml), cefuroxime (30 µg/ml), meropenem (10 µg/ml), chloramphenicol (30 µg/ml), ampicillin-sulbactam (10/10 µg/ml), nalidixic acid (30 µg/ml), and fosfomycin (30 µg/ml), respectively. MIC values of three cefuroxime-resistant isolates was 24, 48 and > 256 µg/ml, respectively; of two meropenem-resistant strains > 256 µg/ml; and of two chloramphenicol-susceptible isolates (by disc diffusion method) 6 µg/ml (considered as intermediate susceptible). Multiple- antibiotics resistance was detected in 15% of the strains, with resistance to 2, 3, 4, 5 and 6 antibiotics in 8.5%, 4%, 2%, 0.5% and 0.5% of the isolates, respectively. By identifying beta-lactamase-negative ampicillin-resistant H. influenzae, empirical therapy with beta-lactam/beta-lactamase inhibitor combinations and second generation cephalosporins would be inappropriate for such patients (approximately 3%). Our findings will contribute to the epidemiological and clinical data regarding H. influenzae infection in Turkey.

levoxacin antibiotics 2016-01-05

Pulmonary Mycobacterium abscessus infection is resistant to many antibiotics and is difficult to treat. We retrospectively analyzed the clinical characteristics of pulmonary infection due to M. abscessus. Eleven cases diagnosed as having pulmonary M. abscessus infection at Osaka Red Cross Hospital from January. 2008, Clindahexal 300 Mg Kapseln to June, 2012 were enrolled in this study. The average age of the 11 cases was 63 years (all were females). Nine cases showed underlying diseases, comprising 5 cases with Mycobacterium avium complex lung infection, 3 with old pulmonary tuberculosis, and 3 with bronchiectasis. The radiological examination revealed that 10 cases showed the small nodular type, 7 showed the bronchiectatic type, 4 showed a cavity lesion and 4 showed infiltrative shadows. A microbiological definite diagnosis was made from sputum in 10 cases and bronchial lavage fluid in one. As treatment for M. abscessus pulmonary infection, combined multi-drug chemotherapy was carried out in 7 of the 11 cases. No patients were successfully treated with antibiotics alone, whereas 4 patients had no exacerbation of radiological findings without any treatment. One patient received antibiotics including clarithromycin, amikacin and levofloxacin for 2 to 12 months following surgical excision and her sputum cultures have been maintained as negative over the long-term. During the study, none of the 11 patients were known to have died. In this study, we found that M. abscessus pulmonary infection is more common among females, and is found frequently in patients with M. avium complex lung infection. We also found that the clinical course of M. abscessus pulmonary infection was different among patients. We think this is because M. abscessus was shown to comprise three closely related species. M. abscessus is extremely difficult to eradicate, and surgical resection of localized disease or the main lesion or cavity may be significantly effective in preventing the progression of disease.