A randomized, double-blind trial comparing azithromycin and clarithromycin in the treatment of disseminated Mycobacterium avium infection in patients with human immunodeficiency virus

investigators in study 066-189

Research output: Contribution to journalArticlepeer-review

53 Scopus citations

Abstract

Two hundred and forty-six patients infected with human immunodeficiency virus (HIV) who also had disseminated Mycobacterium avium complex received either azithromycin 250 mg every day, azithromycin 600 mg every day, or clarithromycin 500 mg twice a day, each combined with ethambutol, for 24 weeks. Samples drawn from patients were cultured and clinically assessed every 3 weeks up to week 12, then monthly thereafter through week 24 of double-blind therapy and every 3 months while on open-label therapy through the conclusion of the trial. The azithromycin 250 mg arm of the study was dropped after an interim analysis showed a lower rate of clearance of bacteremia. At 24 weeks of therapy, the likelihood of patients' developing 2 consecutive negative cultures (46% vs. 56%, P = .24) or 1 negative culture (59% vs. 61%, P = .80) was similar for azithromycin 600 mg (n = 68) and clarithromycin (n = 57), respectively. The likelihood of relapse was 39% versus 27% (P = .21) on azithromycin compared with clarithromycin, respectively. Of the 6 patients who experienced relapse, those randomized to azithromycin developed isolates resistant to macrolides, compared with 2 of 3 patients randomized to clarithromycin. Mortality was similar in patients comprising each arm of the study (69% vs. 63%; hazard, 95.1% confidence interval, 1.1 [0.7, 1.7]). Azithromycin 600 mg, when given in combination with ethambutol, is an effective agent for the treatment of disseminated M. avium disease in patients infected with HIV.

Original languageEnglish (US)
Pages (from-to)1245-1252
Number of pages8
JournalClinical Infectious Diseases
Volume31
Issue number5
DOIs
StatePublished - 2000

ASJC Scopus subject areas

  • Microbiology (medical)
  • Infectious Diseases

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