Clarithromycin Therapy for Mycobacterium avium Complex Disease in Patients with AIDS: Potential and Problems
Authors: Mark Goldberger
Journal: Annals of Internal Medicine (1994)

Editorials15 December 1994Clarithromycin Therapy for Mycobacterium avium Complex Disease in Patients with AIDS: Potential and ProblemsMark Goldberger, MD and Henry Masur, MDMark Goldberger, MDFood and Drug Administration; Rockville, MD 20857National Institutes of Health; Bethesda, MD 20892-1662Search for more papers by this author and Henry Masur, MDFood and Drug Administration; Rockville, MD 20857National Institutes of Health; Bethesda, MD 20892-1662Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-12-199412150-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The quality and duration of survival for patients with human immunodeficiency virus (HIV) infection have improved substantially during the past decade. Much of this improvement has been because of better management of opportunistic infections. However, progress with Mycobacterium avium complex, a pathogen that ultimately infects 30% to 50% of patients with the acquired immunodeficiency syndrome (AIDS) in North America, has until recently been disappointing, especially in terms of prophylaxis and therapy.The development of new rifamycin and macrolide antibiotics has increased optimism among health care providers and patients searching for remedies for disease caused by this Mycobacterium species. Rifabutin, a ...References1. Nightingale SD, Cameron DW, Gordin FM, Sullam PM, Cohn DL, Chaisson RE, et al. Two controlled trials of rifabutin prophylaxis against Mycobacterium avium complex infection in AIDS. N Engl J Med. 1993; 329:828-33. Google Scholar2. Dautzenberg B, Saint Marc T, Meyohas MC, Eliaszewitch M, Haniez F, Rogues AM, et al. Clarithromycin and other antimicrobial agents in the treatment of disseminated Mycobacterium avium infections in patients with acquired immunodeficiency syndrome. 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Br Med J. 1952; 2:735-46. Google Scholar9. Grosset JH. Assessment of new therapies for infection due to the Mycobacterium avium complex: appropriate use of in vitro and in vivo testing. Clin Infect Dis. 1994; 18(Suppl 3):S233-6. Google Scholar10. Kemper CA, Meng TC, Nussbaum J, Chiu J, Feigal DF, Bartok AE, et al. Treatment of Mycobacterium avium-complex bacteremia in AIDS with a four-drug oral regimen. Rifampin, ethambutol, clofazimine, and ciprofloxacin. Ann Intern Med. 1992; 116:466-72. Google Scholar11. Chiu J, Nussbaum J, Bozzette S, Tilles JG, Young LS, Leedom J, et al. Treatment of disseminated Mycobacterium avium complex infection with amikacin, ethambutol, rifampin, and ciprofloxacin. California Collaborative Treatment Group. Ann Intern Med. 1990; 113:358-61. Google Scholar12. Benson CA, Kessler HA, Pottage JC Jr, Trenholme GM. Successful treatment of acquired immunodeficiency syndrome-related Mycobacterium avium complex disease with a multiple drug regimen including amikacin. Arch Intern Med. 1991; 151:582-5. Google Scholar13. Kemper CA, Havlir D, Haghighat D, Dube M, Bartok AE, Sison JP, et al. The individual microbiologic effect of three antimycobacterial agents, clofazimine, ethambutol, and rifampin on Mycobacterium avium complex bacteremia in patients with AIDS. J Infect Dis. 1994; 170:157-64. Google Scholar14. Petty B, Polis M, Haneiwich S, Dellerson M, Craft JC, Chaisson R. Pharmacokinetic assessment of clarithromycin plus zidovudine in HIV patients (Abstract). In: The 32nd Interscience Conference on Antimicrobial Agents and Chemotherapy. Anaheim, California: 11 to 14 October 1992. American Society for Microbiology; 1992:24. Google Scholar15. Perucca E, Grimaldi R, Frigo GM, Sardi A, Monig H, Ohnhaus EE. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: Food and Drug Administration; Rockville, MD 20857National Institutes of Health; Bethesda, MD 20892-1662Disclaimer: This article represents the views of the authors and does not represent official policy of the National Institutes of Health or the Food and Drug Administration. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoClarithromycin Therapy for Bacteremic Mycobacterium avium Complex Disease Richard E. Chaisson , Constance A. Benson , Michael P. Dube , Leonid B. Heifets , Joyce A. Korvick , Saralyn Elkin , Ted Smith , J. Carl Craft , Fred R. Sattler , and Metrics Cited ByIntention-to-treat has implications for study planning and execution, not just subject retention and follow-upCare of the Adult Patient with HIV InfectionProphylactic clarithromycin to treat Mycobacterium avium in HIV patients receiving zidovudine may significantly increase mortality by suppressing lymphopoiesis and hematopoiesisClarithromycin lowers plasma zidovudine levels in persons with human immunodeficiency virus infectionManagement of Mycobacterial Infections in AIDS 15 December 1994Volume 121, Issue 12Page: 974-976KeywordsAIDSAdverse reactionsClinical trialsDrugsFood and Drug AdministrationMycobacterium avium complexPatientsProphylaxisToxicityUveitis Issue Published: 15 December 1994 CopyrightCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...