The clinical efficacy and safety of a fluoroquinolone-containing regimen for pulmonary MAC disease

J Infect Chemother. 2012 Apr;18(2):146-51. doi: 10.1007/s10156-011-0303-5. Epub 2011 Sep 17.


Despite recent advances in chemotherapy, the treatment of pulmonary Mycobacterium avium complex (MAC) disease remains unsatisfactory. Judging from its MIC, fluoroquinolones including gatifloxacin (GFLX) are expected to demonstrate efficacy against MAC disease. However, there have been few clinical studies using fluoroquinolones. Therefore, a prospective study to evaluate the clinical efficacy and safety of a fluoroquinolone-containing regimen for the treatment of pulmonary MAC disease was conducted. In this trial, patients with pulmonary MAC disease received protocol-guided combined chemotherapy with rifampin (RFP) and ethambutol (EB) plus either GFLX or clarithromycin (CAM). Adult patients who fulfilled the criteria of the ATS definition of pulmonary MAC disease were enrolled in this study. The patients provided their informed consent, and treatments were administered for 1 year. Of 27 patients enrolled from three facilities, 14 patients were treated with the CAM-containing regimen and 13 patients were treated with the GFLX-containing regime. Four patients did not complete the 1-year treatment because of adverse events. Nine patients (64.3%) in the CAM group and 11 patients (84.6%) in the GFLX group achieved eradication of pathogens. Adverse events were observed more frequently in the GFLX group than in the CAM group. However, there were no severe adverse events in either group. The long-term results showed a similar relapse rate between the CAM and GFLX groups. The fluoroquinolone-containing regimen demonstrated both high efficacy and relative safety for pulmonary MAC disease that was similar to that of the CAM-containing regimen, which is considered to be the standard regimen.

Publication types

  • Clinical Trial

MeSH terms

  • Aged
  • Antitubercular Agents* / adverse effects
  • Antitubercular Agents* / therapeutic use
  • Clarithromycin* / adverse effects
  • Clarithromycin* / therapeutic use
  • Drug Therapy, Combination
  • Ethambutol / adverse effects
  • Ethambutol / therapeutic use
  • Female
  • Fluoroquinolones* / adverse effects
  • Fluoroquinolones* / therapeutic use
  • Gatifloxacin
  • Humans
  • Lung Diseases / drug therapy*
  • Lung Diseases / microbiology
  • Male
  • Middle Aged
  • Mycobacterium avium Complex / drug effects*
  • Mycobacterium avium-intracellulare Infection / drug therapy*
  • Mycobacterium avium-intracellulare Infection / microbiology
  • Rifampin / adverse effects
  • Rifampin / therapeutic use
  • Treatment Outcome


  • Antitubercular Agents
  • Fluoroquinolones
  • Ethambutol
  • Clarithromycin
  • Gatifloxacin
  • Rifampin