Journal Article

Does In Vitro Susceptibility to Rifabutin and Ethambutol Predict the Response to Treatment of <i>Mycobacterium avium</i> Complex Bacteremia with Rifabutin, Ethambutol, and Clarithromycin?

Stephen D. Shafran, James A. Talbot, Sylvia Chomyc, Estelle Davison, Joel Singer, Peter Phillips, Irving Salit, Sharon L. Walmsley, Ignatius W. Fong, M. John Gill, Anita R. Rachlis and Richard G. Lalonde

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 27, issue 6, pages 1401-1405
Published in print December 1998 | ISSN: 1058-4838
Published online December 1998 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515022
Does In Vitro Susceptibility to Rifabutin and Ethambutol Predict the Response to Treatment of Mycobacterium avium Complex Bacteremia with Rifabutin, Ethambutol, and Clarithromycin?

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The in vitro susceptibilities of baseline Mycobacterium avium complex (MAC) blood isolates from 86 patients with AIDS who were treated with clarithromycin, ethambutol, and rifabutin were determined to examine whether these results predict bacteriologic response to treatment. No patient received prior prophylaxis with clarithromycin or azithromycin. Minimum inhibitory concentrations (MICs) of clarithromycin for all isolates were ⩽2 µg/mL. The median MIC of rifabutin was between 0.25 and 0.5 µg/mL, and all isolates were susceptible to ⩽2 µg of rifabutin/mL. The median MIC of ethambutol was 4 µg/mL, and the MIC90 was 8 µg/mL. There was no correlation between ethambutol susceptibility and subsequent bacteriologic clearance. At all time points through week 12, bacteriologic clearance occurred more frequently in patients with isolates for which MICs of rifabutin were lower, but this difference was statistically significant only at week 2. Susceptibility testing for baseline MAC isolates from AIDS patients not previously treated with clarithromycin or azithromycin does not appear to be useful in guiding therapy.

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Subjects: Infectious Diseases ; Immunology ; Public Health and Epidemiology ; Microbiology

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