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NLM AIDSLINE
Clarithromycin 500mg bid as primary prophylaxis in patients with AIDS.
Grossman HA
December 30, 1994
Int Conf AIDS. 1994 Aug 7-12;10(2):136 (abstract no. PB0557). Unique

Disseminated MAC (dMAC) Infections are a common complication in Patients With AIDS (PWA) occurring almost exclusively in patients with 100 lymphocytes/mm3. The diagnosis of dMAC among PWA's is now being made with increasing frequency. Disseminated MAC is a devastating and costly disease requiring multiple drug therapy, therefore there is great need for new effective regimens for prophylaxis. Clarithromycin (CLA) a semi-synthetic macrolide with documented in-vitro activity against MAI recently received FDA approval for the treatment of dMAC. A retrospective study of PWA's with significantly low CD4 counts who started Clarithromycin 500mg BID was conducted to evaluate CLA for primary prophylaxis. A total of 30 evaluable patients with a mean age of 40.1 (range 28 to 69) were enrolled. Mean CD4 count shortly before or during prophylaxis was 22.3 cells/mm3 (range 0-92). Twenty patients are known to remain dMAC free. Two patients were lost to follow-up after 9 and 14 months of prophylaxis. Eight patients died of AIDS related events. All were clinically free of dMAC disease at the time of death. The average MAC free interval was 10.1 months with an average of 10.8 months for those still alive. Clarithromycin 500 BID seems to be quite effective in preventing dMAC disease in severely immunocompromised patients.

Acquired Immunodeficiency Syndrome/BLOOD/*DRUG THERAPY/IMMUNOLOGY Adult Aged AIDS-Related Opportunistic Infections/COMPLICATIONS/*PREVENTION & CONTROL Clarithromycin/*ADMINISTRATION & DOSAGE CD4-Positive T-Lymphocytes Drug Administration Schedule Human Immunocompromised Host Leukocyte Count Middle Age Mycobacterium avium-intracellulare Infection/COMPLICATIONS/ *PREVENTION & CONTROL Retrospective Studies CLINICAL TRIAL ABSTRACT

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