Prevention of disseminated Mycobacterium avium complex infection with reduced dose clarithromycin in patients with advanced HIV disease.
AIDS
; 13(11): 1367-72, 1999 Jul 30.
Article
de En
| MEDLINE
| ID: mdl-10449290
ABSTRACT
OBJECTIVE:
To evaluate the ability of once daily reduced dose clarithromycin to prevent disseminated Mycobacterium avium complex (dMAC) infection in patients with advanced HIV disease.DESIGN:
Non-randomized, retrospective study.SETTING:
Outpatient clinic of an urban university-affiliated municipal hospital. PATIENTS A group of 192 HIV-infected patients with a CD4 count < 100 x 10(6) cells/l who were followed for at least 90 days during a 6-year period (1991-1996) before the use of protease inhibitors.INTERVENTIONS:
Clarithromycin 500 mg orally once daily (n = 84), rifabutin 300 mg orally once daily (n = 47) or no prophylaxis (n = 61). MAIN OUTCOMEMEASURES:
Positive blood culture for M. avium complex (MAC), time to development of dMAC, and time to death.RESULTS:
When compared with no prophylaxis or rifabutin, the incidence of dMAC and time to development of dMAC were improved among those patients receiving clarithromycin (P < 0.001). Prolonged survival was associated with both clarithromycin and rifabutin use when compared with no prophylaxis (P < 0.002). In patients who failed prophylaxis, resistance to clarithromycin and rifabutin was observed.CONCLUSIONS:
In the era prior to protease inhibitor use, once daily clarithromycin at a dose of 500 mg was associated with a reduction in the incidence of dMAC, appeared to be superior to rifabutin, and was associated with prolonged survival in patients with advanced HIV disease.
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Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Infection due à Mycobacterium avium-intracellulare
/
Clarithromycine
/
Infections opportunistes liées au SIDA
/
Antibioprophylaxie
/
Antibactériens
Type d'étude:
Observational_studies
/
Risk_factors_studies
Limites:
Adult
/
Female
/
Humans
/
Male
Langue:
En
Journal:
AIDS
Sujet du journal:
SINDROME DA IMUNODEFICIENCIA ADQUIRIDA (AIDS)
Année:
1999
Type de document:
Article
Pays d'affiliation:
États-Unis d'Amérique