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NLM AIDSLINE

Controlled trial of clarithromycin/ethambutol with or without clofazimine for Mycobacterium avium complex bacteremia in AIDS.




 

3rd Conf Retro and Opportun Infect. 1996 Jan 28-Feb 1;:164. Unique

To compare the efficacy of a 2- and 3-drug regimen for treating MAC bacteremia, 106 AIDS patients with MAC were treated with clarithromycin (CLR) 0.5 g bid, ethambutol (EMB) 15 mg/kg/d and were randomized to receive clofazimine (CLO) 100 mg/d or no CLO. Baseline blood cultures were positive in 89. The proportion becoming culture negative was 65% in the 2-drug group and 54% in the 3-drug group. The median time to negative culture was 58 days for 2-drug patients and 63 days for 3-drug patients. At the end of treatment, the mean reduction in log CFUs of MAC was 1.8 for 2-drug patients and 2.3 for 3-drug patients. One patient had a baseline MIC greater than 8 and one patient developed resistance during therapy. Improvement in fever and night sweats was reported by 87% of 2-drug patients and 84% of 3-drug patients. The proportion of patients withdrawn for adverse events was 13% in the 2-drug group and 22% in the 3-drug group. 38% of 2-drug patients and 61% of 3-drug patients died (p=0.03), and time to death was shorter in patients treated with 3 drugs (p=0.01). CLR/EMB is effective in treating MAC bacteremia and preventing resistance. The addition of CLO does not contribute to clinical response and is associated with higher mortality.

Acquired Immunodeficiency Syndrome/*COMPLICATIONS Anti-Infective Agents/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Bacteremia Clarithromycin/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Clofazimine/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Ethambutol/ADMINISTRATION & DOSAGE/*THERAPEUTIC USE Human Mycobacterium avium-intracellulare Infection/BLOOD/COMPLICATIONS/ *DRUG THERAPY ABSTRACT



 




Information in this article was accurate in November 30, 1996. The state of the art may have changed since the publication date. This material is designed to support, not replace, the relationship that exists between you and your doctor. Always discuss treatment options with a doctor who specializes in treating HIV.