[The short-term effects of multidrug chemotherapy for pulmonary Mycobacterium avium-intracellulare complex (MAC) infection]. 1998

A Kurashima
Department of Pulmonary Medicine, National Tokyo Hospital, Japan.

In performing MAC chemotherapy, we are faced with the following two problems: first, unlike for Mycobacterium tuberculosis, we have neither any suitable bacteriocidal drugs nor bacteriocidal regimens for MAC treatment; secondly, in case of MAC, unlike in the case of Mycobacterium tuberculosis, in vitro sensitivity does not correlate with in vivo sensitivity. For these reasons, we find difficulty in planning a rational protocol for MAC treatment, and thus depend on previous experiences of other physicians in MAC chemotherapy. Here, we have tried to evaluate such previous experiences objectively, and studied retrospectively the effects of previous combination chemotherapy cases of pulmonary MAC infections at National Tokyo Hospital. We selected 170 cases which had received the same chemotherapy continuously over a period of six months. Concentration of bacilli cultured, 8 weeks in Ogawa solid egg containing medium was translated semi-quantitatively to colony forming units (CFU) according to the Japanese guideline for acid fast bacilli test. Having set a mean CFU of 3 times sputum culture before treatment as 100%, we calculated a six month sequential bacillary response to a regimen and plotted the bacillary response curves. The response curve of the total 170 MAC treatment cases exhibits a minimum point of 42.9% at 2 months, and subsequently rises to 71.1% after six months compared to the state before treatment. The response curves of various regimens of multidrug chemotherapy indicate that combinations of more than 3 drugs including aminoglycoside and clarithromycin are most effective. However, although some effectiveness is indicated, neither the present drugs nor regimens are capable to achieve a bacteriocidal effect in MAC treatment.

UI MeSH Term Description Entries
D008297 Male Males
D004359 Drug Therapy, Combination Therapy with two or more separate preparations given for a combined effect. Combination Chemotherapy,Polychemotherapy,Chemotherapy, Combination,Combination Drug Therapy,Drug Polytherapy,Therapy, Combination Drug,Chemotherapies, Combination,Combination Chemotherapies,Combination Drug Therapies,Drug Polytherapies,Drug Therapies, Combination,Polychemotherapies,Polytherapies, Drug,Polytherapy, Drug,Therapies, Combination Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000995 Antitubercular Agents Drugs used in the treatment of tuberculosis. They are divided into two main classes: "first-line" agents, those with the greatest efficacy and acceptable degrees of toxicity used successfully in the great majority of cases; and "second-line" drugs used in drug-resistant cases or those in which some other patient-related condition has compromised the effectiveness of primary therapy. Anti-Tuberculosis Agent,Anti-Tuberculosis Agents,Anti-Tuberculosis Drug,Anti-Tuberculosis Drugs,Antitubercular Agent,Antitubercular Drug,Tuberculostatic Agent,Tuberculostatic Agents,Antitubercular Drugs,Agent, Anti-Tuberculosis,Agent, Antitubercular,Agent, Tuberculostatic,Anti Tuberculosis Agent,Anti Tuberculosis Agents,Anti Tuberculosis Drug,Anti Tuberculosis Drugs,Drug, Anti-Tuberculosis,Drug, Antitubercular
D014397 Tuberculosis, Pulmonary MYCOBACTERIUM infections of the lung. Pulmonary Consumption,Pulmonary Phthisis,Pulmonary Tuberculoses,Pulmonary Tuberculosis,Tuberculoses, Pulmonary,Consumption, Pulmonary,Consumptions, Pulmonary,Phthises, Pulmonary,Phthisis, Pulmonary,Pulmonary Consumptions,Pulmonary Phthises
D015270 Mycobacterium avium-intracellulare Infection A nontuberculous infection when occurring in humans. It is characterized by pulmonary disease, lymphadenitis in children, and systemic disease in AIDS patients. Mycobacterium avium-intracellulare infection of birds and swine results in tuberculosis. Mycobacterium intracellulare Infection,Infection, Mycobacterium avium-intracellulare,Infection, Mycobacterium intracellulare,Mycobacterium avium intracellulare Infection,Infection, Mycobacterium avium intracellulare,Infections, Mycobacterium avium-intracellulare,Infections, Mycobacterium intracellulare,Mycobacterium avium-intracellulare Infections,Mycobacterium intracellulare Infections

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