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M9550089.TXT
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1995-03-04
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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
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).