Koletar S L, Berry A J, Cynamon M H, Jacobson J, Currier J S, MacGregor R R, Dunne M W, Williams D J
The Ohio State University Medical Center, Columbus, Ohio 43210, USA.
Antimicrob Agents Chemother. 1999 Dec;43(12):2869-72. doi: 10.1128/AAC.43.12.2869.
This multicenter, randomized, dose-ranging study was performed to determine the safety and efficacy of two different doses of azithromycin for treating disseminated Mycobacterium avium complex (MAC) in patients with AIDS. Eighty-eight AIDS patients with symptoms and blood cultures consistent with disseminated MAC were treated with 600 or 1,200 mg of azithromycin daily for 6 weeks; 62 patients completed the entire 6 weeks of study. Of note, this study was done prior to the time when combination antiretroviral or anti-MAC regimens were the standard of care. Over the 6-week study period, symptomatic improvement was noted in both dose groups. Microbiological responses were comparable, with mean decreases of 1. 5 and 2.0 log CFU/ml in the high- and low-dose groups, respectively. Sterilization of blood cultures occurred in 54% of samples; patients with lower baseline colony counts were more likely to achieve culture negativity. Resistance developed in one patient. Gastrointestinal symptoms were the most common side effects and were more frequent in patients receiving 1,200 mg. Azithromycin is a useful alternative treatment for disseminated MAC infection in AIDS patients. Symptomatic improvement correlates with measurable decreases in mycobacterial load.
这项多中心、随机、剂量范围研究旨在确定两种不同剂量的阿奇霉素治疗艾滋病患者播散性鸟分枝杆菌复合体（MAC）的安全性和有效性。88例有症状且血培养结果与播散性MAC相符的艾滋病患者，每天接受600毫克或1200毫克阿奇霉素治疗，为期6周；62例患者完成了整个6周的研究。值得注意的是，这项研究是在联合抗逆转录病毒或抗MAC方案成为标准治疗方法之前进行的。在为期6周的研究期间，两个剂量组均出现了症状改善。微生物学反应相当，高剂量组和低剂量组的平均菌落形成单位（CFU）/毫升分别下降了1.5和2.0个对数。54%的血培养样本实现了灭菌；基线菌落计数较低的患者更有可能实现培养转阴。有1例患者出现了耐药。胃肠道症状是最常见的副作用，在接受1200毫克治疗的患者中更为频繁。阿奇霉素是艾滋病患者播散性MAC感染的一种有用的替代治疗方法。症状改善与分枝杆菌载量的可测量下降相关。
