Yamamoto M, Kuze F, Sakatani M, Saito H, Shimoide H, Soejima R, Hara K
Nagoya Medical Examination Center, Postal Life Insurance Welfare Corporation, Nagoya, Japan.
Kekkaku. 1997 Jan;72(1):1-7.
A nationwide study was conducted to investigate the efficacy of Clarithromycin (CAM) on pulmonary atypical mycobacteriosis caused by the Mycobacterium avium-Mycobacterium intracellulare complex, including intractable cases. Out of total 97 patients examined, the analysis for bacteriological efficacy was possible in 69 cases. The negative conversion of bacilli was observed in 18 cases (26.1%), and 5 out of 12 cases in which the follow-up was conducted turned out continued negative status. The efficacy of CAM was relatively high in the following cases: the duration of the disease was less than 6 months the extent of pulmonary lesions on chest roentogenograms was limited or moderate; and antituberculous agents which were previously unused were applied in combination with CAM. Also, the efficacy was high in cases where the dose of CAM was 600 mg/day or higher. Major side effect was mill to moderate digestive symptoms. In conclusion, at daily dose of 600 mg or higher, CAM was effective in the elimination or reduction of M avium M. intracellulare complex that caused atypical mycobacteriosis, without developing serious side effect. Treatment with this drug should be attempted in intractable cases.
开展了一项全国性研究，以调查克拉霉素（CAM）对鸟分枝杆菌-胞内分枝杆菌复合群引起的肺部非典型分枝杆菌病的疗效，包括难治性病例。在总共检查的97例患者中，69例可进行细菌学疗效分析。18例（26.1%）观察到杆菌转阴，在进行随访的12例患者中，有5例持续呈阴性状态。在以下情况下，CAM的疗效相对较高：病程少于6个月；胸部X线片上肺部病变范围有限或中等；以前未使用过的抗结核药物与CAM联合使用。此外，CAM剂量为600mg/天或更高的病例疗效较高。主要副作用为轻度至中度消化系统症状。总之，每日剂量600mg或更高时，CAM可有效清除或减少引起非典型分枝杆菌病的鸟分枝杆菌-胞内分枝杆菌复合群，且不会产生严重副作用。对于难治性病例，应尝试使用该药物进行治疗。
