Yonsei Med J.  2010 Nov;51(6):888-894. 10.3349/ymj.2010.51.6.888.

Standardized Combination Antibiotic Treatment of Mycobacterium avium Complex Lung Disease

• Sim YS
• Park HY
• Jeon K
• Suh GY
• Kwon OJ
• Koh WJ

• KMID: 1779636
• DOI: http://doi.org/10.3349/ymj.2010.51.6.888

Abstract

PURPOSE
The optimal treatment regimen for Mycobacterium avium complex (MAC) lung disease has not yet been fully established. We evaluated the efficacy of standardized combination antibiotic therapy and the factors that might affect unfavorable microbiologic responses in patients with MAC pulmonary disease.
MATERIALS AND METHODS
This retrospective study reviewed data from 96 patients (56 females; median age 59 years) treated with newly diagnosed MAC lung disease between January 2003 and December 2006.
RESULTS
All patients received standardized combination antibiotic therapy, consisting of clarithromycin, rifampicin, and ethambutol. Streptomycin was additionally given in 72 patients (75%) for a median duration of 4.5 months. The overall favorable microbiologic response rate was 79% (76/96); 20 patients (21%) had unfavorable microbiologic responses, including failure to sputum conversion (n = 13), relapse (n = 3), and MAC-related death (n = 4). A positive sputum acid-fast bacillus smear at the start of treatment was an independent predictor of an unfavorable microbiologic response.
CONCLUSION
Standardized combination antibiotic therapy consisting of clarithromycin, rifampicin, and ethambutol with or without initial use of streptomycin is effective in treating patients with newly diagnosed MAC lung disease.

Keyword

Atypical mycobacteria; lung diseases; Mycobacterium avium complex; treatment outcomes

MeSH Terms

Aged
Anti-Bacterial Agents/*therapeutic use
Clarithromycin/therapeutic use
Drug Therapy, Combination/*methods
Ethambutol/therapeutic use
Female
Humans
Lung Diseases/*drug therapy/*microbiology
Male
Middle Aged
Mycobacterium Infections/*drug therapy
Mycobacterium avium/*metabolism
Retrospective Studies
Rifampin/therapeutic use
Streptomycin/therapeutic use
Treatment Outcome

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