Document 0089
 DOCN  M9550089
 TI    [Therapeutic efficacy of macrolide in pulmonary nontuberculous
       mycobacteriosis]
 DT    9505
 AU    Tomono K; Second Department of Internal Medicine, Nagasaki University;
       School of Medicine, Japan.
 SO    Kekkaku. 1994 Nov;69(11):725-32. Unique Identifier : AIDSLINE
       MED/95139539
 AB    Clarithromycin (CAM) is semi-synthetic macrolide antimicrobial agent,
       differing from erythromycin by an O-methyl substitution at position 6 of
       the 14-membered lactate ring. CAM is one of the very few antimicrobial
       agents that show activity against that Mycobacterium avium complex (MAC)
       in vivo, in vitro, and in AIDS patients with disseminated infections.
       The purpose of the present study was to evaluate the therapeutic
       efficacy of CAM against MAC in patients with chronic pulmonary MAC
       infection. In vitro activity against clinically isolated MAC; MIC was
       evaluated by liquid medium dilution method. CAM was the most effective
       than other antitubercular drugs against M. avium, but less effective
       than RFP against M. intracellulare. Activity in animal model of
       infection; In vivo activity was evaluated by the murine models of
       hematogenous pulmonary MAC infection. A dose-related reduction in lung
       cell counts was noted with treatment at 10, 50, 150, and 300 mg/kg of
       body weight administrated daily. Histopathological examinations were
       revealed also the reduction of the numbers of granulomas in the lungs
       with treatment CAM at 300 mg/kg. Therapeutic efficacy of CAM in chronic
       pulmonary MAC infection; Thirty patients with chronic pulmonary MAC
       infection were given CAM with other antitubercular drugs. Nineteen of 30
       patients had previously received combination antimycobacterial therapy.
       The overall efficacy rates were 23.3%, and ten patients (33.3%) had
       negative sputum culture for MAC. Eradication of MAC from sputum has been
       almost observed within 3 months of initiating treatment, and the
       patients those who had no cavitation were effective. In conclusion, CAM
       was considerably effective against chronic pulmonary MAC infection, and
       the effect was observed relatively rapid.
 DE    Aged  Aged, 80 and over  Animal  Chronic Disease
       Clarithromycin/*THERAPEUTIC USE  English Abstract  Female  Human  Male
       Mice  Mice, Inbred BALB C  Middle Age  Mycobacterium
       avium-intracellulare Infection/*DRUG THERAPY  Tuberculosis,
       Pulmonary/*DRUG THERAPY  CLINICAL TRIAL  JOURNAL ARTICLE

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