Hoy J, Mijch A, Sandland M, Grayson L, Lucas R, Dwyer B
Fairfield Infections Diseases Hospital, Melbourne, Australia.
J Infect Dis. 1990 Apr;161(4):801-5. doi: 10.1093/infdis/161.4.801.
The mycobacterial response was evaluated for patients with Mycobacterium avium-intracellulare complex (MAC) bacteremia treated with a quadruple regimen of rifabutin, clofazimine, isoniazid, and ethambutol. Mycobacteremia was cleared in 22 of 25 patients who received this regimen, and 18 patients experienced complete resolution of symptoms associated with MAC infection. All of the patients were immunodeficient, with a mean CD4 cell count at the time of diagnosis of MAC infection of 54.7 +/- 54.6 cells/microliters. All MAC isolates were resistant to clofazimine, isoniazid, and ethambutol. Sixteen of 24 isolates were resistant to rifabutin. Improved results of treatment may be related to the use of a higher dose of rifabutin (300-600 mg/day) compared with other studies (150-300 mg/day), earlier diagnosis and institution of treatment, and synergy between rifabutin and ethambutol. The quadruple regimen used in this study appears effective in clearing mycobacteremia and in ameliorating symptoms of infection.
对接受利福布汀、氯法齐明、异烟肼和乙胺丁醇四联疗法治疗的鸟分枝杆菌-胞内分枝杆菌复合体（MAC）菌血症患者的分枝杆菌反应进行了评估。在接受该疗法的25例患者中，22例患者的分枝杆菌血症得到清除，18例患者与MAC感染相关的症状完全缓解。所有患者均免疫缺陷，MAC感染诊断时的平均CD4细胞计数为54.7±54.6个/微升。所有MAC分离株对氯法齐明、异烟肼和乙胺丁醇均耐药。24株分离株中有16株对利福布汀耐药。与其他研究（150 - 300毫克/天）相比，使用更高剂量的利福布汀（300 - 600毫克/天）、更早的诊断和治疗以及利福布汀与乙胺丁醇之间的协同作用可能是治疗效果改善的原因。本研究中使用的四联疗法似乎对清除分枝杆菌血症和改善感染症状有效。
