[Nontuberculous mycobacteriosis; the present status and in the future. 3-(2) Long-term prognosis of Mycobacterium avium complex disease].
This paper shows long-term course of 71 patients with Mycobacterium avium complex (MAC) disease treated in National Hiroshima Hospital between 1977 and 1991 and were observed for more than 5 years or died between 6 months and years from the onset. In the patients who were not treated with chemotherapeutic agent or treated with less than 3 drugs, about 60 per cent deteriorated and few obtained persistent negativity of bacteria. In patients treated with at least 3 drugs out of isoniazid, rifampicin, ethambutol, ethionamide, cycloserine, clarithromycin and new-quinolones for more than 12 months, 59.2 per cent deteriorated, while 29.6 per cent obtained negative conversion of bacteria by initial chemotherapy. However only 18.5 per cent remained negative during long term observation. In patients treated with at least 3 drugs including one aminoglycoside such as streptomycin for more than 12 months, 64.7 per cent obtained negative conversion and 35.5 per cent remained negative bacteriologically, while 23.5 per cent deteriorated. In twelve patients who were operated, only one patient deteriorated. The long-term prognosis of MAC disease under the chemotherapy mainly by antituberculous agents up to this time was still poor compared to that by short-term observation. Anticipated new regimens for MAC should be multidrug, to prevent secondary drug resistance.
Shigeto
E
E
National Hiroshima Hospital, Japan.
D005500:Follow-Up Studies; D006801:Humans; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy*; D011379:Prognosis