Treatment Outcome of Combination Therapy Including Clarithromycin for Mycobacterium avium Complex Pulmonary Disease.
10.3904/kjim.2011.26.1.54
- Author:
Eun Young KIM
1
;
Su Young CHI
;
In Jae OH
;
Kyu Sik KIM
;
Yu Il KIM
;
Sung Chul LIM
;
Young Chul KIM
;
Yong Soo KWON
Author Information
1. Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea. yskwon@chonnam.ac.kr
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Mycobacterium avium complex;
Treatment outcome;
Clarithromycin
- MeSH:
Aged;
Anti-Bacterial Agents/*administration & dosage;
Clarithromycin/*administration & dosage/adverse effects;
Drug Therapy, Combination;
Female;
Humans;
Lung Diseases/*drug therapy;
Male;
Middle Aged;
Mycobacterium avium-intracellulare Infection/*drug therapy;
Retrospective Studies;
Treatment Outcome
- From:The Korean Journal of Internal Medicine
2011;26(1):54-59
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The frequency of nontuberculous mycobacteria pulmonary disease in HIV-negative patients is increasing; the most common pathogen in Korea is the Mycobacterium avium complex (MAC). However, few studies have evaluated the treatment outcome of MAC pulmonary disease in Korea. METHODS: The efficacy of a clarithromycin-containing regimen for MAC pulmonary disease was studied in 42 patients treated for more than 6 months between January 2005 and December 2008. All patients were treated with a regimen consisting of clarithromycin, rifampin, and ethambutol. Streptomycin was added in 10 patients. RESULTS: Among the 42 patients, a negative culture conversion was achieved in 33 (78.6%), and the median duration of treatment in these patients was 19 months (interquartile range [IQR], 16 to 22). Of the 33 patients with a negative culture conversion, 14 completed treatment. During the follow-up period (median, 10 months; IQR, 4 to 20) for the 14 patients, one relapsed at 24 months after treatment completion. The culture conversion rate was significantly higher in patients who were treated with more than 500 mg/day clarithromycin (87.1% vs. 54.5%, p = 0.038). CONCLUSIONS: The combined regimen including clarithromycin was effective against MAC pulmonary disease. High-dose clarithromycin of more than 500 mg/day may improve the outcome of patients with MAC pulmonary disease.
