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Titolo:
A prospective randomized trial of four three-drug regimens in the treatment of disseminated Mycobacterium avium complex disease in AIDS patients: Excess mortality associated with high-dose clarithromycin
Autore:
Cohn, DL; Fisher, EJ; Peng, GT; Hodges, JS; Chesnut, J; Child, CC; Franchino, B; Gibert, CL; El-Sadr, W; Hafner, R; Korvick, J; Ropka, M; Heifets, L; Clotfelter, J; Munroe, D; Horsburgh, CR;
Indirizzi:
Denver Community Program Clin Res AIDS, Denver, CO USA Denver Community Program Clin Res AIDS Denver CO USA IDS, Denver, CO USA Richmond AIDS Consortium, Richmond, VA USA Richmond AIDS Consortium Richmond VA USA DS Consortium, Richmond, VA USA Univ Minnesota, Sch Publ Hlth, Minneapolis, MN USA Univ Minnesota Minneapolis MN USA ta, Sch Publ Hlth, Minneapolis, MN USA Social & Sci Syst, Rockville, MD USA Social & Sci Syst Rockville MD USASocial & Sci Syst, Rockville, MD USA Univ Calif San Francisco, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Washington Reg AIDS Program, Washington, DC USA Washington Reg AIDS Program Washington DC USA rogram, Washington, DC USA Columbia Univ Coll Phys & Surg, Harlem Hosp Ctr, New York, NY 10032 USA Columbia Univ Coll Phys & Surg New York NY USA 10032 w York, NY 10032 USA NIAID, Bethesda, MD 20892 USA NIAID Bethesda MD USA 20892NIAID, Bethesda, MD 20892 USA Natl Inst Nursing Res, NIH, Bethesda, MD USA Natl Inst Nursing Res Bethesda MD USA Nursing Res, NIH, Bethesda, MD USA Natl Jewish Med & Res Ctr, Denver, CO USA Natl Jewish Med & Res Ctr Denver CO USA sh Med & Res Ctr, Denver, CO USA Louisiana Community AIDS Res Program, New Orleans, LA USA Louisiana Community AIDS Res Program New Orleans LA USA Orleans, LA USA Emory Univ, Sch Med, Atlanta, GA USA Emory Univ Atlanta GA USAEmory Univ, Sch Med, Atlanta, GA USA
Titolo Testata:
CLINICAL INFECTIOUS DISEASES
fascicolo: 1, volume: 29, anno: 1999,
pagine: 125 - 133
SICI:
1058-4838(199907)29:1<125:APRTOF>2.0.ZU;2-O
Fonte:
ISI
Lingua:
ENG
Soggetto:
HUMAN-IMMUNODEFICIENCY-VIRUS; IMMUNE-DEFICIENCY-SYNDROME; COMBINATION THERAPY; INFECTED PATIENTS; IN-VITRO; BACTEREMIA; ETHAMBUTOL; RIFABUTIN; CLOFAZIMINE; SURVIVAL;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
45
Recensione:
Indirizzi per estratti:
Indirizzo: Cohn, DL Denver Publ Hlth, 605 Bannock St, Denver, CO 80204 USA Denver Publ Hlth 605 Bannock St Denver CO USA 80204 CO 80204 USA
Citazione:
D.L. Cohn et al., "A prospective randomized trial of four three-drug regimens in the treatment of disseminated Mycobacterium avium complex disease in AIDS patients: Excess mortality associated with high-dose clarithromycin", CLIN INF D, 29(1), 1999, pp. 125-133

Abstract

The optimal regimen for treatment of Mycobacterium avium complex (MAC) disease has not been established. Eighty-five AIDS patients with disseminated MAC disease were randomized to receive a three-drug regimen of clarithromycin, rifabutin or clofazimine, and ethambutol. Two dosages of clarithromycin, 500 or 1,000 mg twice daily (b.i.d.), were compared. The Data and Safety Monitoring Board recommended discontinuation of the clarithromycin dosage comparison and continuation of the rifabutin vs. clofazimine comparison. After a mean follow-up of 4.5 months, 10 (22%) of 45 patients receiving clarithromycin at 500 mg b.i.d. had died (70 deaths per 100 person-years) compared with 17 (43%) of 30 patients receiving clarithromycin at 1,000 mg b.i.d. (158 deaths per 100 person-years) (relative risk, 2.43; 95% confidence interval, 1.11-5.34; P = .02). After 10.4 months, 20 (49%) of 41 patients receiving rifabutin had died (81 deaths per 100 person-years) compared with 23 (52%) of 44 patients receiving clofazimine (94 deaths per 100 person-years) (relative risk, 1.20; 95% confidence interval, 0.65-2.19; P = .56). Bacteriologic outcomes were similar among treatment groups. In treating MAC disease in AIDS patients, the maximum dose of clarithromycin should be 500 mg b.i.d.

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Documento generato il 25/11/20 alle ore 10:24:52