title: Pharmacokinetic/pharmacodynamic-based treatment of disseminated Mycobacterium avium.
abstract: Disseminated Mycobacterium avium complex (MAC) is treated with a macrolide and ethambutol. However, the kill rates are extremely slow so that therapy takes many months to years to achieve and even then more than 40% of patients are not completely cured. Recent studies have demonstrated that assays that detect extracellular MAC have a limited predictive value. Antibiotics kill at a much slower and more disappointing rate against bacilli within macrophages. Use of pharmacodynamic/pharmacokinetic models has resulted in design of new doses and dosing schedules for disseminated MAC, as well as new susceptibility breakpoints for ethambutol and moxifloxacin.
authors.affiliation: Division of Infectious Diseases, UT Southwestern Medical Center, Dallas, TX 75390-9113, USA.
authors.forename: Devyani
authors.initials: D
authors.lastname: Deshpande
authors.forename: Tawanda
authors.initials: T
authors.lastname: Gumbo
mesh_terms: D000900:Anti-Bacterial Agents / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use*; D001372:Aza Compounds / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D004977:Ethambutol / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D024841:Fluoroquinolones; D006801:Humans; D018942:Macrolides / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D008826:Microbial Sensitivity Tests; D000077266:Moxifloxacin; D015269:Mycobacterium avium Complex / Q000187:drug effects*; D015270:Mycobacterium avium-intracellulare Infection / Q000188:drug therapy* / Q000382:microbiology; D011804:Quinolines / Q000493:pharmacokinetics / Q000494:pharmacology / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D018942:Macrolides; D011804:Quinolines; D004977:Ethambutol; D000077266:Moxifloxacin