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Being Alive

MEDICAL UPDATE: Mycobutin Approved As MAC Prophylaxis


Being Alive 1993 Mar 5: 8

Mycobutin (generic name: rifabutin) has now received FDA approval as a drug to help prevent MAC. This is a significant step forward. We now have a second opportunistic infection (PCP is the other) for which approved prophylaxis exists.

Disseminated MAC is a late-stage infection that is usually only seen in PWAs with less than 50 T-cells. The seriousness of the infection is evident from the statistics. MAC is the single greatest cause of death from AIDS in Los Angeles County. So it is very good news indeed that we now have an approved prophylactic drug.

The not so good news about Mycobutin is that studies indicate that the drug is not a completely successful preventative. Researchers estimate that use of rifabutin could about halve the occurrence of MAC. This is in contrast to Bactrim/Septra's use as prophylaxis for PCP, where the drug almost completely prevents new occurrences.

The major side effects of Mycobutin are rashes which were seen in about 11% of study subjects. The established prophylactic dosage is two 150 mg pills once a day or 150 mg twice daily if there are problems with nausea. Note that rifabutin is not being used as treatment for MAC; clofazimine and clarithromycin remain the standard of care for treatment once disseminated MAC infection is diagnosed. 


Information in this article was accurate in March 5, 1993. 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.