Chest
Original ResearchChest InfectionsMacrolide/Azalide Therapy for Nodular/Bronchiectatic Mycobacterium avium Complex Lung Disease
Section snippets
Materials and Methods
Patients treated at The University of Texas Health Science Center, Tyler, (UTHSCT), Texas, for NB MAC lung disease not previously reported are included in this report. The clinical treatment outcome studies, retrospective chart reviews, and maintenance of a database were approved by the Institutional Review Board of UTHSCT (Institutional Review Board #760, #11-009).
Daily therapy consisted of rifampin 600 mg or rifabutin 150 mg, ethambutol 15 mg/kg, clarithromycin 1,000 mg in divided doses or 15
Results
Two hundred seven consecutively treated patients were started on MAC therapy for NB MAC lung disease during the study period. Twenty-seven patients were excluded from the main analysis because they did not receive at least 12 months of macrolide/azalide-based therapy, leaving 180 patients who met the inclusion criteria for analysis. Fifty-five of 180 patients (31%) received > 6 months macrolide-based therapy prior to treatment at our facility. Twenty-one patients (15%) received either
Discussion
Patients with macrolide-susceptible NB MAC lung disease had a high rate of sputum conversion to AFB culture negative (86%) with macrolide/azalide-based regimens. There were no significant differences in microbiologic responses between clarithromycin and azithromycin treatment regimens. Overall treatment success was achieved in 84% of patients. Consistent with prior reports, our findings support currently recommended macrolide/azalide treatment regimens for NB MAC lung disease.4, 5, 11, 20, 23
Acknowledgments
Author contributions: R. J. W. is guarantor of the manuscript. R. J. W., B. A. B.-E., S. M., J. V. P., J. K., R. W. W., D. S. Y., S. S., and D. E. G. contributed to conception and design; data acquisition, analysis, and interpretation; drafting and critical revision of the submitted article for important intellectual content; final approval of the version to be published; and accountability for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part
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Data included in this manuscript were presented in part at the American Thoracic Society Annual Meeting, May 14-19, 2010, New Orleans, LA.
FUNDING/SUPPORT: This manuscript was supported in part by institutional funds from the University of Texas Health Science Center, Tyler and the Carter Foundation (Dr Wallace) and the Moncrief Foundation (Dr Griffith).
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.