title: Treatment outcome of combination therapy including clarithromycin for Mycobacterium avium complex pulmonary disease.
abstract: OBJECTIVE
  The frequency of nontuberculous mycobacteria pulmonary disease in HIV-negative patients is increasing; the most common pathogen in Korea is the Mycobacterium avium complex (MAC). However, few studies have evaluated the treatment outcome of MAC pulmonary disease in Korea.
  
  
  METHODS
  The efficacy of a clarithromycin-containing regimen for MAC pulmonary disease was studied in 42 patients treated for more than 6 months between January 2005 and December 2008. All patients were treated with a regimen consisting of clarithromycin, rifampin, and ethambutol. Streptomycin was added in 10 patients.
  
  
  RESULTS
  Among the 42 patients, a negative culture conversion was achieved in 33 (78.6%), and the median duration of treatment in these patients was 19 months (interquartile range [IQR], 16 to 22). Of the 33 patients with a negative culture conversion, 14 completed treatment. During the follow-up period (median, 10 months; IQR, 4 to 20) for the 14 patients, one relapsed at 24 months after treatment completion. The culture conversion rate was significantly higher in patients who were treated with more than 500 mg/day clarithromycin (87.1% vs. 54.5%, p = 0.038).
  
  
  CONCLUSIONS
  The combined regimen including clarithromycin was effective against MAC pulmonary disease. High-dose clarithromycin of more than 500 mg/day may improve the outcome of patients with MAC pulmonary disease.
authors: Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors: Eun Young
authors: EY
authors: Kim
authors: Su Young
authors: SY
authors: Chi
authors: In Jae
authors: IJ
authors: Oh
authors: Kyu Sik
authors: KS
authors: Kim
authors: Yu Il
authors: YI
authors: Kim
authors: Sung Chul
authors: SC
authors: Lim
authors: Young Chul
authors: YC
authors: Kim
authors: Yong Soo
authors: YS
authors: Kwon
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D017291:Clarithromycin / Q000008:administration & dosage* / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D017291:Clarithromycin