Chaisson RE, Keiser P, Pierce M, Fessel WJ, Ruskin J, Lahart C, Meek K; Conference on Retroviruses and Opportunistic Infections.
Program Abstr 3rd Conf Retrovir Oppor Infect Conf Retrovir Oppor Infect 3rd 1996 Wash D C. 1996 Jan 28-Feb 1; 3rd: 164.
Johns Hopkins Univ., Baltimore, MD.
To compare the efficacy of a 2- and 3-drug regimen for treating MAC bacteremia, 106 AIDS patients with MAC were treated with clarithromycin (CLR) 0.5 g bid, ethambutol (EMB) 15 mg/kg/d and were randomized to receive clofazimine (CLO) 100 mg/d or no CLO. Baseline blood cultures were positive in 89. The proportion becoming culture negative was 65% in the 2-drug group and 54% in the 3-drug group. The median time to negative culture was 58 days for 2-drug patients and 63 days for 3-drug patients. At the end of treatment, the mean reduction in log CFUs of MAC was 1.8 for 2-drug patients and 2.3 for 3-drug patients. One patient had a baseline MIC greater than 8 and one patient developed resistance during therapy. Improvement in fever and night sweats was reported by 87% of 2-drug patients and 84% of 3-drug patients. The proportion of patients withdrawn for adverse events was 13% in the 2-drug group and 22% in the 3-drug group. 38% of 2-drug patients and 61% of 3-drug patients died (p=0.03), and time to death was shorter in patients treated with 3 drugs (p=0.01). CLR/EMB is effective in treating MAC bacteremia and preventing resistance. The addition of CLO does not contribute to clinical response and is associated with higher mortality.
Publication Types:
Keywords:
- Acquired Immunodeficiency Syndrome
- Clarithromycin
- Clinical Trials as Topic
- Clofazimine
- Ethambutol
- Humans
- Microbial Sensitivity Tests
Other ID:
UI: 102216654
From Meeting Abstracts