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A phase II/III trial of Rifampin (RIF) Ciprofloxach (CIPRO), Clofazimine (CLOF), Ethambutol (ETH), +/- Amikacin (AK) in the treatment (RX) of Disseminated Mycobacterium avium (MA) infection in HIV-infected individuals (PTS).

Parent D, Ellner J, Hafner R, Williams M, Jacobs P, Hojczyk P; National Conference on Human Retroviruses and Related Infections.

Program Abstr Second Natl Conf Hum Retrovir Relat Infect Natl Conf Hum Retrovir Relat Infect 2nd 1995 Wash DC. 1995 Jan 29-Feb 2; 56.

George Washington Univ., Washington DC.

79 symptomatic HIV-infected PTS with MA infection were enrolled in a Phase II/III study of RIF 600 mg/d, CIPRO 500 mg bid, CLOF 100 mg/d ETH 15mg/kg/d+/-AK 10 mg/kg/d x 4 wks. After a 1-2 wk observation period, 37 PTS were randomized to receive AK, 37 to the non-AK arm, and 5 were not randomized. Baseline characteristics were comparable: median CD4=10, median Kamovsky score=70. The median duration of RX was 12 wks w/median followup of 23 wks. PTS were classified as complete or partial responders on the basis of decreases in clinical symptoms of fever, diarrhea, and antipyretic use after 4, 8, and 12 wks of RX. At 4 wks, 33% of PTS randomized to AK had a complete or partial response vs 35% in the non-AK arm (Fisher's exact test=0.65); at 8 wks 62% vs 65% (p=0.70). Although there was no significant difference between groups, overall the mean proportion of febrile days decreased from 74% to 43% (p less than 0.001) at 4 wks, 24% at 8 wks. The mean proportion of days of antipyretic use decreased from 68% to 49% (p less than 0.001) at 4 wks, 31% at 8 wks. Quantitative cultures showed no significant difference between the AK and non-AK arms in the decrease in mean log10 CFU relative to baseline at any visit, but the overall decline among all PTS relative to baseline was significant at 4 and 12 weeks of RX. Mean log10 CFU for AK and non-AK arms were 2.11 and 1.70 at baseline 1.53 and 0.99 after 4 wks, and 0.47 and 0.62 after 12 wks. The proportion of negative cultures increased in similar fashion. 13 PTS died within the first 12 wks, 24 during the remainder of study, 10 after study discontinuation. There was no difference between RX arms in after study discontinuation. There no was difference between RX arms in survival distributions (logrank test p=0.83). The addition to AK to this four-drug oral regimen did not provide additional clinical or microbiological benefit.

Publication Types:
  • Meeting Abstracts
Keywords:
  • AIDS Vaccines
  • AIDS-Related Opportunistic Infections
  • Acquired Immunodeficiency Syndrome
  • Amikacin
  • Bacteremia
  • Ciprofloxacin
  • Clinical Trials as Topic
  • Clofazimine
  • Communicable Diseases
  • Drug Therapy, Combination
  • Ethambutol
  • HIV Seropositivity
  • Humans
  • Infection
  • Mycobacterium avium
  • Mycobacterium avium Complex
  • Mycobacterium avium-intracellulare Infection
  • Physical Therapy Modalities
  • Rifampin
  • drug therapy
  • therapy
Other ID:
  • 95920040
UI: 102212985

From Meeting Abstracts




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