Clarithromycin in the Treatment of Mycobacterium avium Lung Infections in Patients Without AIDS

Dautzenberg, Bertrand; Piperno, D.; Diot, Patrice; Truffot-Pernot, C.; Chauvin, Jean‐Paul

doi:10.1378/chest.107.4.1035

Cited by 130 publications

(57 citation statements)

References 30 publications

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“…The clinical characteristics of the patients with MAC disease in this present study were consistent with those in previous reports (4), i.e., the patients were predominantly slim, middle-aged to elderly women with nodular bronchiectatic (NB) disease. The initial culture conversion rate of 76.5% in response to the chemotherapy was also similar to the results from previous reports (18,20,23). The observed GPL core IgA seropositive rate of 85.3% was higher than the 69.6% (95% CI ϭ 62.1 to 76.1%) reported in the meta-analysis (17).…”

Section: Discussionsupporting

confidence: 89%

Levels of Antibody against Glycopeptidolipid Core as a Marker for Monitoring Treatment Response in Mycobacterium avium Complex Pulmonary Disease: a Prospective Cohort Study

et al. 2017

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The diagnosis of Mycobacterium avium complex pulmonary disease (MAC-PD) is sometimes complicated and time-consuming. A serodiagnostic kit that measures the serum levels of IgA antibodies against the glycopeptidolipid (GPL) core is commercially available and has good diagnostic accuracy for MAC-PD. However, the significance of measurement of GPL core IgA antibody levels in monitoring for chemotherapy response in patients with MAC-PD was not well investigated. Thirty-four treatment naive MAC-PD patients who were started on multidrug chemotherapy were enrolled. Their antibody levels were prospectively measured at regular intervals. The relationships between their antibody levels and the therapeutic outcomes were examined. The patients were classified into three groups (conversion, recurrence, and nonconversion) based on the bacteriological outcomes after chemotherapy. There were no significant differences in the antibody levels before treatment between the culture conversion (n ϭ 19), recurrence (n ϭ 7), and nonconversion (n ϭ 8) groups (P ϭ 0.9881). The levels decreased significantly after the chemotherapy (P Ͻ 0.0001). Recurrence and/or worsening of chest radiography findings were observed in cases whose antibody levels subsequently increased after cessation of the chemotherapy. No significant difference in the percent decrease in antibody levels by the chemotherapy was observed between the culture conversion and recurrence groups (P ϭ 0.9338). The initial antibody levels are not a predictor of therapeutic outcomes, and also the percent decrease in antibody levels is not a sufficient indicator of the cessation of chemotherapy. However, serial measurements of antibody levels may allow objective monitoring of disease activity in individual MAC-PD patients.

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Section: Discussionsupporting

confidence: 89%

Levels of Antibody against Glycopeptidolipid Core as a Marker for Monitoring Treatment Response in Mycobacterium avium Complex Pulmonary Disease: a Prospective Cohort Study

et al. 2017

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“…Treatment outcomes for noncavitary MAC lung disease have been generally favorable with macrolide-containing regimens. [3][4][5] Unfortunately, there are no predictable or reliably eff ective treatment strategies for lung disease caused by Mab with a functional erythromycin resistance methlyase gene ( erm ). 6 MAC and Mab lung diseases are similar to multidrug-resistant TB (MDR-TB) in that there are relatively few treatment options available, especially for patients who fail "standard" therapy.…”

Section: [ 1 4 8 # 2 C H E S T a U G U S T 2 0 1 5 ]mentioning

confidence: 99%

Preliminary Results of Bedaquiline as Salvage Therapy for Patients With Nontuberculous Mycobacterial Lung Disease

Philley

Wallace

Benwill

et al. 2015

Chest

199

148

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“…There could be scope further improve survival by better management of comorbid conditions and by improving the general health of the patient. It may be that macrolides and/or quinolones, which, during the period of this study, were found to have in vitro activity against opportunist mycobacteria [14][15][16][17][18], will result in better cure rates when added to rifampicin and ethambutol. The British Thoracic Society9s ongoing multicentre trial should answer this question by the end of 2004.…”

Section: Discussionmentioning

confidence: 93%

Pulmonary disease caused byM. malmoensein HIV negative patients: 5‐yr follow-up of patients receiving standardised treatment

2003

Eur Respir J

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Pulmonary disease caused by M. malmoense in HIV negative patients:5-yr follow-up of patients receiving standardised treatment When two positive cultures were confirmed by the Mycobacterium Reference Units for England, Wales, Scotland or Scandinavia, the coordinating physician invited the patient9s physician to enrol the patient, who was then treated on a random basis with either rifampicin plus ethambutol or rifampicin, ethambutol and isoniazid for 2 yrs. Clinical, bacteriological and radiological progress were monitored at set intervals for 5 yrs.In over 5 yrs a total of 106 patients were recruited to the study. The mean age was 58 yrs, range 24-89 yrs. A total of 58% were male and just over half previously or at the time of the study had other lung diseases. Sputum was positive on direct smear in 58%. Cavitation was seen on the chest radiographs of 74%, the majority having cavities of o2 cm in diameter. Less than half of the patients showed bilateral disease, 26% having involvement of more than three lung zones. Disease was confined to the upper zone(s) in 30%. Other lung diseases were evident in 52%. Although clinical response was judged satisfactory at most reviews (90%), one in three patients died within 5 yrs andv5% were thought to have died primarily because of M. malmoense. There were three failures of treatment and eight relapses after the end of treatment. There was no correlation between failure of treatment/relapse and in vitro resistance. A total of 63 (59%) of patients were alive at 5 yrs, of whom 44 (42% of the total entry) were known to be cured.Pulmonary disease caused by Mycobacterium malmoense is a serious condition that is associated with high morbidity and mortality. The results of standard susceptibility tests do not correlate with the bacteriological response of the disease to chemotherapy. Rifampicin and ethambutol, with or without isoniazid, cured only 42% of patients but were better tolerated than previously described, more complex regimens of equal or lesser efficacy. There is a need for more effective regimens that will reduce mortality and failure of treatment/relapse rates, but, in addition, attention should be directed at improving management of comorbid conditions and improving the general health of the patient.

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Clarithromycin in the Treatment of Mycobacterium avium Lung Infections in Patients Without AIDS

Cited by 130 publications

References 30 publications

Levels of Antibody against Glycopeptidolipid Core as a Marker for Monitoring Treatment Response in Mycobacterium avium Complex Pulmonary Disease: a Prospective Cohort Study

Levels of Antibody against Glycopeptidolipid Core as a Marker for Monitoring Treatment Response in Mycobacterium avium Complex Pulmonary Disease: a Prospective Cohort Study

Preliminary Results of Bedaquiline as Salvage Therapy for Patients With Nontuberculous Mycobacterial Lung Disease

Pulmonary disease caused byM. malmoensein HIV negative patients: 5‐yr follow-up of patients receiving standardised treatment

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