Thrice-Weekly Clarithromycin-Containing Regimen for Treatment of Mycobacterium kansasii Lung Disease: Results of a Preliminary Study

• Published in: Clinical infectious diseases Vol. 37; no. 9; pp. 1178 - 1182
• Main Authors: Griffith, David E., Brown-Elliott, Barbara A., Wallace, Richard J.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.11.2003; University of Chicago Press
• Subjects: Anti-Bacterial Agents - therapeutic use; Antibacterial agents; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antitubercular Agents - therapeutic use; Biological and medical sciences; Clarithromycin - therapeutic use; Drug Therapy, Combination; Ethambutol - therapeutic use; Female; Fungal infections; Fungal lung diseases; Hematocrit; Humans; Infections; Lung diseases; Lung Diseases - drug therapy; Major Articles; Male; Medical sciences; Middle Aged; Mycobacterium avium complex; Mycobacterium Infections, Nontuberculous - drug therapy; Mycobacterium kansasii; Pharmacology. Drug treatments; Pulmonary tuberculosis; Relapse; Sputum; Clarithromycin; Male; Rifampicin; Intermittent; Bacteria; Female; Antituberculous agent; Woman; Human; Lung disease; Respiratory disease; Mycobacterium kansasii; Duration; Recurrent; Macrolide; Standards; Antibiotic; Treatment; Mycobacteriales; Sputum; Mycobacteriaceae; Ethambutol; Actinomycetes; End; Antibacterial agent
• ISSN: 1058-4838; 1537-6591
• DOI: 10.1086/378742

We initiated a prospective trial of an intermittent clarithromycin-containing regimen for the treatment of patients with Mycobacterium kansasii lung disease. Eighteen patients (10 men and 8 women) with M. kansasii lung disease received a regimen consisting of 500–1000 mg of clarithromycin, 25 mg/kg ethambutol, and 600 mg of rifampin 3 times per week. The primary treatment end point was a 12-month period during which sputum cultures were sterile while the patient was receiving therapy. Four male patients were lost to follow-up, but all of the remaining patients successfully completed therapy without significant drug-related adverse events. The mean time (± standard deviation [SD]) to sputum conversion was 1.0 ± 0.9 months, and the mean duration (±SD) of therapy was 13.4 ± 0.9 months. No patient who successfully completed therapy had relapsed after a mean (±SD) of 46 ± 8.0 months. Clarithromycin- and rifampin-containing regimens offer the possibility of effective short-course and intermittent treatment of M. kansasii lung disease.