Efficacy and outcomes of clarithromycin treatment for pulmonary MAC disease.
METHODS
Retrospective review of patients with pulmonary Mycobacterium avium complex (MAC) disease treated with clarithromycin.


OBJECTIVE
To investigate whether the short-term response to treatment predicts long-term outcomes, and to analyse what explanatory variables are associated with the efficacy and outcome of treatment.


METHODS
Sputum conversion rates in short- and long-term outcomes were evaluated for 111 patients. Respectively 9 and 10 explanatory variables were analysed for their association with both response and outcomes.


RESULTS
Eighty-four patients (75.7%) showed good short-term response and 94 (82.0%) showed good long-term outcomes. Women and patients with satisfactory nutrition status showed good short-term response. Patients with small lesions and those treated for >12 months after sputum conversion showed good long-term outcomes. Patients who showed good short-term response, in the group with large lesions, showed significantly good long-term outcomes (P = 0.0382).


CONCLUSIONS
There were differences between prognostic factors reflecting short-term response and long-term outcomes. The short-term response predicts long-term outcomes in certain groups divided by prognostic factor. To establish standard treatment for pulmonary MAC disease, it is important to determine a standardised method of evaluation of treatment taking such factors into consideration.
Fujikane
T
T
Department of Respiratory Medicine, Dohoku National Hospital, Asahikawa, Japan. fujikane@douhoku.hosp.go.jp
Fujiuchi
S
S
Yamazaki
Y
Y
Sato
M
M
Yamamoto
Y
Y
Takeda
A
A
Nishigaki
Y
Y
Fujita
Y
Y
Shimizu
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017291:Clarithromycin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy*; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D017291:Clarithromycin