Early results (at 6 months) with intermittent clarithromycin-including regimens for lung disease due to Mycobacterium avium complex

Clin Infect Dis. 2000 Feb;30(2):288-92. doi: 10.1086/313644.

Abstract

We initiated a prospective noncomparative trial of treatment for lung disease due to Mycobacterium avium complex (MAC) in human immunodeficiency virus-negative patients, with a regimen of clarithromycin (1000 mg), rifabutin (300-600 mg), and ethambutol (25 mg/kg) administered 3 times per week. Fifty-nine patients were enrolled. Twelve (20%) were lost to follow-up, and 6 (10%) developed clarithromycin intolerance. The remaining 41 patients (69%) completed the initial 6 months of therapy. The sputum of 32 of these patients (78%) converted to negative. When results were compared with the sputum response rates at 6 months in previous studies with a regimen including daily clarithromycin and regimens including intermittent (3 times per week) azithromycin with the same companion drugs, no differences in treatment responses were evident. Adverse reactions related to rifabutin were a major problem, and for 24 (41%) of 59 patients the dosage was decreased or the drug was withdrawn. Intermittent (3 times per week) administration of clarithromycin appears to be as effective as daily administration in effecting sputum conversion in pulmonary MAC disease.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Clarithromycin / administration & dosage*
  • Drug Administration Schedule
  • Drug Therapy, Combination / administration & dosage*
  • Ethambutol / administration & dosage*
  • Female
  • Follow-Up Studies
  • HIV Seronegativity
  • Humans
  • Lung Diseases / drug therapy*
  • Lung Diseases / microbiology
  • Male
  • Middle Aged
  • Mycobacterium avium Complex / drug effects
  • Mycobacterium avium-intracellulare Infection / diagnosis
  • Mycobacterium avium-intracellulare Infection / drug therapy*
  • Prospective Studies
  • Rifabutin / administration & dosage*
  • Sputum / drug effects
  • Sputum / microbiology
  • Treatment Outcome

Substances

  • Rifabutin
  • Ethambutol
  • Clarithromycin