The effect of antimycobacterial treatment on survival of AIDS patients with disseminated Mycobacterium avium complex infection (DMAC).

Important note: Information in this article was accurate in 1993. The state of the art may have changed since the publication date.

The effect of antimycobacterial treatment on survival of AIDS patients with disseminated Mycobacterium avium complex infection (DMAC).

Abstr Gen Meet Am Soc Microbiol. 1993;93:174 (abstract no. U-35). Unique Identifier : AIDSLINE ASM93/93291795
Otte J; Rimland D; Ivester K; Atlanta Veterans Affairs Medical Center (AVAMC), GA.

Abstract: DMAC has become the most common bacterial infection in later stages of AIDS. In order to assess the impact of DMAC, with or without specific therapy, on survival we retrospectively reviewed all patients with AIDS seen at AVAMC between 1981 and 1992. Treatment for DMAC was first used in 1989; since that time treatment has generally consisted of a four-drug oral regimen--one with ciprofloxacin (treatment A), the other with clarithromycin (treatment B). A total of 75 patients had DMAC, 265 had AIDS without DMAC. Of the patients with DMAC, 36 received specific treatment (27, treatment A; 11, treatment B). The median survival for DMAC patients was longer than AIDS patients without DMAC (16 mos vs 9.2 mos). DMAC patients were more likely to have received PCP prophylaxis (p = .0058), have had PCP (p = .004), and were younger than controls (p = .0237). The median survival for treated DMAC patients from the time of DMAC diagnosis was longer than those not receiving treatment (6.8 vs 3.5 mos). Treated patients were more likely to have received PCP prophylaxis (p = .0007) and to have been diagnosed after 1989 (p = .0007). There was no difference in survival between the two treatment regimens. DMAC does not worsen the survival of patients with AIDS. Several factors complicate this analysis, including the earlier diagnosis of DMAC and the recent use of antiretroviral and prophylactic regimens. Our analysis suggests that therapy for DMAC does improve survival, but there is no obvious difference between the two regimens used here. Prospective studies will be necessary to definitely answer these questions.

Keywords: Acquired Immunodeficiency Syndrome/*MORTALITY Antibiotics, Combined/*THERAPEUTIC USE AIDS-Related Opportunistic Infections/*DRUG THERAPY/*MORTALITY Ciprofloxacin/*THERAPEUTIC USE Clarithromycin/*THERAPEUTIC USE Comparative Study Human Mycobacterium avium-intracellulare Infection/*DRUG THERAPY/ ETIOLOGY/MORTALITY Survival Analysis Time Factors CLINICAL TRIAL ABSTRACT
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M9391176

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