Successful Short-Term Suppression of Clarithromycin-Resistant Mycobacterium avium Complex Bacteremia in AIDS

During a randomized study of clarithromycin plus clofazimine with or without ethambutol in patients with AIDS and Mycobacterium avium complex (MAC) bacteremia, eight participants received additional antimycobacterial drugs following the detection of a clarithromycin-resistant isolate (MIC, >8 µg/...

Full description

Saved in:
Bibliographic Details
Published in:Clinical infectious diseases 1999-01, Vol.28 (1), p.136-138
Main Authors: Dubé, Michael P., Torriani, Francesca J., See, Darryl, Havlir, Diane V., Kemper, Carol A., Leedom, John M., Tilles, Jeremiah G., McCutchan, J. Allen, Sattler, Fred R.
Format: Article
Language:English
Subjects:
AIDS
Antibacterial agents
Antibiotics. Antiinfectious agents. Antiparasitic agents
Bacteremia
Biological and medical sciences
Blood
Experimentation
Fungal diseases
Fungal infections
Human viral diseases
Infectious diseases
Macrolides
Medical sciences
Mycobacterium avium complex
Nadir
Pharmacology. Drug treatments
Relapse
Viral diseases
Viral diseases of the lymphoid tissue and the blood. Aids
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:During a randomized study of clarithromycin plus clofazimine with or without ethambutol in patients with AIDS and Mycobacterium avium complex (MAC) bacteremia, eight participants received additional antimycobacterial drugs following the detection of a clarithromycin-resistant isolate (MIC, >8 µg/mL). A macrolide (seven received clarithromycin, one azithromycin) and clofazimine were continued; additional treatment included various combinations of ethambutol, ciprofloxacin, amikacin, and rifabutin. After the detection of a resistant isolate and before receipt of additional antimycobacterials, the median peak MAC colony count in blood was 105 cfu/mL (range, 8–81,500 cfu/mL). After additional antimycobacterials, the median nadir MAC colony count was 5 cfu/mL (range, 0–110 cfu/mL). Five (63%) of eight patients had a ⩾1 log10 decrease, including two who achieved negative blood cultures; all of these responses occurred in patients originally assigned to clarithromycin plus clofazimine. Treatment of clarithromycin-resistant MAC bacteremia that emerges during clarithromycin-based treatment can decrease levels of bacteremia and transiently sterilize blood cultures.
ISSN:1058-4838
1537-6591
DOI:10.1086/515078