A retrospective comparison of clarithromycin versus rifampin in combination treatment for disseminated Mycobacterium avium complex disease in AIDS: clarithromycin decreases transfusion requirements

Burman, W.J.; Reves, R.R.; Rietmeijer, C.A.; Cohn, D.L.

International Journal of Tuberculosis and Lung Disease the Official Journal of the International Union Against Tuberculosis and Lung Disease 1(2): 163-169


ISSN/ISBN: 1027-3719
PMID: 9441082
Accession: 002741782

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Clinical outcomes associated with 2 treatment regimens for AIDS-associated disseminated Mycobacterium avium complex (DMAC) were compared in a retrospective review. From 1989 to mid-1992, patients were treated with rifampicin, ethambutol, and clofazimine; in mid-1992 clarithromycin replaced rifampicin. 88 patients received the rifampicin-based regimen and 86 were treated with the clarithromycin-based regimen. Drug-related adverse events were recorded less frequently with clarithromycin treatment (21% vs. 42%, P = 0.005), and additional antimycobacterial agents were used less often (28% vs. 44%, P = 0.04). In a multivariate logistic regression model, severe anaemia at the time of DMAC diagnosis was associated with transfusion-dependence (relative risk [RR] 5.6, 95% confidence interval [CI] 2.2, 13.8, P <0.001) and clarithromycin treatment was inversely associated with transfusion dependence (RR 0.4, 95% CI 0.1, 0.98, P = 0.04). In a multivariate Cox regression model including other factors affecting survival, clarithromycin treatment did not confer a survival advantage (P = 0.74).