The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Treatment Outcome of Combination Therapy Including Clarithromycin for Mycobacterium avium Complex Pulmonary Disease

  • Kim, Eun-Young (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Chi, Su-Young (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Oh, In-Jae (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Kyu-Sik (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Yu-Il (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Lim, Sung-Chul (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Young-Chul (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kwon, Yong-Soo (Department of Internal Medicine, Chonnam National University Hospital)
  • Published : 2011.03.01
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Abstract

Background/Aims: The frequency of nontuberculous mycobacteria pulmonary disease in HIV-negative patients is increasing; the most common pathogen in Korea is the Mycobacterium avium complex (MAC). However, few studies have evaluated the treatment outcome of MAC pulmonary disease in Korea. Methods: The efficacy of a clarithromycin-containing regimen for MAC pulmonary disease was studied in 42 patients treated for more than 6 months between January 2005 and December 2008. All patients were treated with a regimen consisting of clarithromycin, rifampin, and ethambutol. Streptomycin was added in 10 patients. Results: Among the 42 patients, a negative culture conversion was achieved in 33 (78.6%), and the median duration of treatment in these patients was 19 months (interquartile range [IQR], 16 to 22). Of the 33 patients with a negative culture conversion, 14 completed treatment. During the follow-up period (median, 10 months; IQR, 4 to 20) for the 14 patients, one relapsed at 24 months after treatment completion. The culture conversion rate was significantly higher in patients who were treated with more than 500 mg/day clarithromycin (87.1% vs. 54.5%, p = 0.038). Conclusions: The combined regimen including clarithromycin was effective against MAC pulmonary disease. High-dose clarithromycin of more than 500 mg/day may improve the outcome of patients with MAC pulmonary disease.

Keywords

References

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