title: Efficacy and outcomes of clarithromycin treatment for pulmonary MAC disease.
abstract: 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.
authors.affiliation: Department of Respiratory Medicine, Dohoku National Hospital, Asahikawa, Japan. fujikane@douhoku.hosp.go.jp
authors.forename: T
authors.initials: T
authors.lastname: Fujikane
authors.forename: S
authors.initials: S
authors.lastname: Fujiuchi
authors.forename: Y
authors.initials: Y
authors.lastname: Yamazaki
authors.forename: M
authors.initials: M
authors.lastname: Sato
authors.forename: Y
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: A
authors.initials: A
authors.lastname: Takeda
authors.forename: Y
authors.initials: Y
authors.lastname: Nishigaki
authors.forename: Y
authors.initials: Y
authors.lastname: Fujita
authors.forename: T
authors.initials: T
authors.lastname: Shimizu
mesh_terms: 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*
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin