Standardized combination antibiotic treatment of Mycobacterium avium complex lung disease

The optimal treatment regimen for Mycobacterium avium complex (MAC) lung disease has not yet been fully established. We evaluated the efficacy of standardized combination antibiotic therapy and the factors that might affect unfavorable microbiologic responses in patients with MAC pulmonary disease....

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Published in:Yonsei medical journal 2010, 51(6), , pp.888-894
Main Authors: Sim, Yun Su, Park, Hye Yun, Jeon, Kyeongman, Suh, Gee Young, Kwon, O Jung, Koh, Won-Jung
Format: Article
Language:English
Subjects:
Aged
Anti-Bacterial Agents - therapeutic use
Clarithromycin - therapeutic use
Drug Therapy, Combination - methods
Ethambutol - therapeutic use
Female
Humans
Lung Diseases - drug therapy
Lung Diseases - microbiology
Male
Middle Aged
Mycobacterium avium - metabolism
Mycobacterium Infections - drug therapy
Original
Retrospective Studies
Rifampin - therapeutic use
Streptomycin - therapeutic use
Treatment Outcome
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Summary:The optimal treatment regimen for Mycobacterium avium complex (MAC) lung disease has not yet been fully established. We evaluated the efficacy of standardized combination antibiotic therapy and the factors that might affect unfavorable microbiologic responses in patients with MAC pulmonary disease. This retrospective study reviewed data from 96 patients (56 females; median age 59 years) treated with newly diagnosed MAC lung disease between January 2003 and December 2006. All patients received standardized combination antibiotic therapy, consisting of clarithromycin, rifampicin, and ethambutol. Streptomycin was additionally given in 72 patients (75%) for a median duration of 4.5 months. The overall favorable microbiologic response rate was 79% (76/96); 20 patients (21%) had unfavorable microbiologic responses, including failure to sputum conversion (n = 13), relapse (n = 3), and MAC-related death (n = 4). A positive sputum acid-fast bacillus smear at the start of treatment was an independent predictor of an unfavorable microbiologic response. Standardized combination antibiotic therapy consisting of clarithromycin, rifampicin, and ethambutol with or without initial use of streptomycin is effective in treating patients with newly diagnosed MAC lung disease.
ISSN:0513-5796
1976-2437
DOI:10.3349/ymj.2010.51.6.888