MICs and MBCs of clarithromycin for M. avium isolated from AIDS patients. NLM AIDSLINE Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

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MICs and MBCs of clarithromycin for M. avium isolated from AIDS patients.

Abstr Annu Meet Am Soc Microbiol. 1991 May 5-9;91:152 (abstract no. U-60). Unique Identifier : AIDSLINE ASM91/0110292
Heifets L; Comstock D; Lindholm-Levy P; Natl. Jewish Ctr. Immunol. Respir. Med., Denver, CO.

Abstract: Clarithromycin is the only antimicrobial agent that has been tested in a controlled clinical trial for the therapy of M. avium infection. This trial, conducted in France, has shown the ability of this drug to eliminate M. avium from the blood of AIDS patients. The aim of our study was to determine bacteriostatic and bactericidal activity of clarithromycin against M. avium in vitro. Both MICs and MBCs were determined in 7H12 broth. The MICs ranged from 0.12 to 0.5 microgram/ml when tested at pH 7.4, 0.25 to less than 2.0 microgram/ml at pH 6.8, 2.0 to 8.0 microgram/ml at pH 6.0, and 4.0 to greater than 16.0 microgram/ml at pH 5.0. The MICs of the metabolite of clarithromycin (14-OH) were substantially higher even at pH 7.4: 4.0 to 16.0 microgram/ml, resulting in MIC:MBC ratio of 1:32. These data indicate that clarithromycin has a very low bactericidal potency, and its clinical efficacy is probably related to its high bacteriostatic activity at pH 7.4, which is to the pH of blood. It remains to be shown whether the higher MICs found under acidic conditions can be achieved within macrophages, and whether the drug is active against the intracellular bacterial population of M. avium.
Keywords: Acquired Immunodeficiency Syndrome/COMPLICATIONS/*MICROBIOLOGY Clinical Trials Erythromycin/ANALOGS & DERIVATIVES/*PHARMACOLOGY Human Microbial Sensitivity Tests Mycobacterium avium Complex/*DRUG EFFECTS Mycobacterium avium-intracellulare Infection/DRUG THERAPY ABSTRACTKWDacquiredimmunodeficiencysyndrome/complications/KWDmicrobiologyclinicaltrialserythromycin/analogs&derivatives/KWDpharmacologyhumanmicrobialsensitivitytestsmycobacteriumaviumcomplex/KWDdrugeffectsmycobacteriumavium-intracellulareinfection/drugtherapyabstract
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