A randomized evaluation of ethambutol for prevention of relapse and drug resistance during treatment of Mycobacterium avium complex bacteremia with clarithromycin-based combination therapy. California Collaborative Treatment Group.

Patients with AIDS and Mycobacterium avium complex (MAC) bacteremia are at high risk for relapse and emergence of resistant isolates during monotherapy with clarithromycin. Ninety-five AIDS patients with MAC bacteremia received clarithromycin plus clofazimine, with or without ethambutol, in a prospective, multicenter, randomized open-label trial. Of 80 patients with positive baseline cultures, sterilization or a 2 log10 reduction in colony-forming units of MAC in two consecutive blood cultures occurred in 69% of both groups. There were nine relapses in the two-drug arm and three in the three-drug arm. Kaplan-Meier estimates of risk of relapse at 36 weeks were 68% and 12%, respectively (P = .004). All relapse isolates were resistant to clarithromycin. Median time to clarithromycin resistance was 16 weeks with two drugs and 40 weeks with three drugs (P = .004). Ethambutol reduced relapses and emergence of clarithromycin resistance and should be considered an essential component of clarithromycin-based therapies for MAC bacteremia.
AuthorsM P Dubé, F R Sattler, F J Torriani, D See, D V Havlir, C A Kemper, M G Dezfuli, S A Bozzette, A E Bartok, J M Leedom, J G Tilles, J A McCutchan
JournalThe Journal of infectious diseases (J Infect Dis) Vol. 176 Issue 5 Pg. 1225-32 (Nov 1997) ISSN: 0022-1899 [Print] United States
PMID9359722 (Publication Type: Clinical Trial, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Bacterial Agents
  • Antitubercular Agents
  • Ethambutol
  • Clarithromycin
  • Adult
  • Anti-Bacterial Agents (administration & dosage)
  • Antitubercular Agents (administration & dosage)
  • Bacteremia (drug therapy)
  • Clarithromycin (administration & dosage, adverse effects)
  • Drug Resistance, Microbial
  • Drug Therapy, Combination
  • Ethambutol (administration & dosage, adverse effects)
  • Female
  • Humans
  • Male
  • Mycobacterium avium-intracellulare Infection (drug therapy)
  • Prospective Studies
  • Recurrence

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!

Choose Username:
Verify Password:
Enter Code Shown: