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Antimicrobial Agents and Chemotherapy, December 1999, p. 2869-2872, Vol. 43, No. 12
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Azithromycin as Treatment for Disseminated Mycobacterium avium Complex in AIDS Patients

Susan L. Koletar,1,* Alison J. Berry,2 Michael H. Cynamon,3 Jeffrey Jacobson,4 Judith S. Currier,5 Rob Roy MacGregor,6 Michael W. Dunne,7 and Debra J. Williams7

The Ohio State University Medical Center, Columbus, Ohio1; Audie Murphy Veterans Administration Hospital, San Antonio, Texas2; State University of New York, Syracuse,3 and Department of Veteran Affairs Medical Center, Bronx,4 New York; Beth Israel Hospital, Boston, Massachusetts5; University of Pennsylvania, Philadelphia, Pennsylvania6; and Pfizer Central Research, Groton, Connecticut7

Received 8 April 1999/Returned for modification 27 April 1999/Accepted 13 September 1999

This multicenter, randomized, dose-ranging study was performed to determine the safety and efficacy of two different doses of azithromycin for treating disseminated Mycobacterium avium complex (MAC) in patients with AIDS. Eighty-eight AIDS patients with symptoms and blood cultures consistent with disseminated MAC were treated with 600 or 1,200 mg of azithromycin daily for 6 weeks; 62 patients completed the entire 6 weeks of study. Of note, this study was done prior to the time when combination antiretroviral or anti-MAC regimens were the standard of care. Over the 6-week study period, symptomatic improvement was noted in both dose groups. Microbiological responses were comparable, with mean decreases of 1.5 and 2.0 log CFU/ml in the high- and low-dose groups, respectively. Sterilization of blood cultures occurred in 54% of samples; patients with lower baseline colony counts were more likely to achieve culture negativity. Resistance developed in one patient. Gastrointestinal symptoms were the most common side effects and were more frequent in patients receiving 1,200 mg. Azithromycin is a useful alternative treatment for disseminated MAC infection in AIDS patients. Symptomatic improvement correlates with measurable decreases in mycobacterial load.

* Corresponding author. Mailing address: N-1135 Doan Hall, 410 W. 10th Ave., Columbus, OH 43210. Phone: (614) 293-8745. Fax: (614) 293-4556. E-mail: koletar.1{at}osu.edu.

Antimicrobial Agents and Chemotherapy, December 1999, p. 2869-2872, Vol. 43, No. 12
0066-4804/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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