Clarithromycin and other antimicrobial agents in the treatment of disseminated Mycobacterium avium infections in patients with acquired immunodeficiency syndrome

B. Dautzenberg, T. S. Marc, M. C. Meyohas, M. Eliaszewitch, F. Haniez, A. M. Rogues, S. De Wit, L. Cotte, J. P. Chauvin, J. Grosset

Research output: Contribution to journalArticle

Abstract

Background: Disseminated infection with Mycobacterium avium is common with late-stage acquired immunodeficiency syndrome (AIDS), and no antimicrobial agent has been found to be clearly effective. Methods: A multicenter open trial was conducted to assess the antimicrobial activity and clinical efficacy of clarithromycin-a new macrolide antibiotic-against disseminated M avium in 77 patients with late-stage AIDS. Blood cultures were taken at baseline and during treatment; side effects were also evaluated. Results: Mycobacterium avium was eradicated from blood cultures in 11 (63%) of 16 evaluable patients receiving daily doses or 500 or 1000 mg, (n=21) and in 45 of 46 (98%) of those receiving 1500 or 2000 mg (n=56). Eradication after 2 months was influenced by continuity of drug treatment. 36 of 42 patients with no relapse had received continuous treatment vs six of 14 patients whose drug treatment had been stopped for 7 days or longer. After 2 to 7 months of treatment, acquired resistance associated with relapse was observed. Drug side effects were elevated liver enzyme levels (26%) and impaired hearing (4%). Concomitant AIDS drugs had no favorable effect on outcome and may have worsened liver toxicity. Conclusions: Clarithromycin has bacteriologic efficacy against M avium infection in late-stage AIDS, although drug resistance eventually develops. Further studies are needed to investigate safe, effective concomitant drugs.

Original languageEnglish (US)
Pages (from-to)368-372
Number of pages5
JournalArchives of internal medicine
Volume153
Issue number3
DOIs
StatePublished - Feb 17 1993

ASJC Scopus subject areas

  • Internal Medicine

Fingerprint Dive into the research topics of 'Clarithromycin and other antimicrobial agents in the treatment of disseminated Mycobacterium avium infections in patients with acquired immunodeficiency syndrome'. Together they form a unique fingerprint.

  • Cite this

    Dautzenberg, B., Marc, T. S., Meyohas, M. C., Eliaszewitch, M., Haniez, F., Rogues, A. M., De Wit, S., Cotte, L., Chauvin, J. P., & Grosset, J. (1993). Clarithromycin and other antimicrobial agents in the treatment of disseminated Mycobacterium avium infections in patients with acquired immunodeficiency syndrome. Archives of internal medicine, 153(3), 368-372. https://doi.org/10.1001/archinte.153.3.368