Journal Article

Successful Short-Term Suppression of Clarithromycin-Resistant <i>Mycobacterium avium</i> Complex Bacteremia in AIDS

Michael P. Dubé, Francesca J. Torriani, Darryl See, Diane V. Havlir, Carol A. Kemper, John M. Leedom, Jeremiah G. Tilles, J. Allen McCutchan and Fred R. Sattler

in Clinical Infectious Diseases

Published on behalf of Infectious Diseases Society of America

Volume 28, issue 1, pages 136-138
Published in print January 1999 | ISSN: 1058-4838
Published online January 1999 | e-ISSN: 1537-6591 | DOI: http://dx.doi.org/10.1086/515078
Successful Short-Term Suppression of Clarithromycin-Resistant Mycobacterium avium Complex Bacteremia in AIDS

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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.

Journal Article.  0 words. 

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

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