Important note: Information in this article was accurate in 1996. The state of the art may have changed since the publication date.

Reuters NewMedia, Inc. - 7 August 1996
Gene Emery

The ailment, Mycobacterium avium, is the third most common infection in AIDS patients. One in five people with AIDS will typically develop it.

The findings, from studies that looked at various drug regimens, "are welcome news," said Dr. Robert Horsburgh Jr. of Emory University in Atlanta. All the studies are being published in Thursday's New England Journal of Medicine.

In the first study, a group led by Dr. Stephen Shafran of the University of Alberta in Edmonton, Canada, found that a combination of three drugs cleared up the infection in 78 percent of the patients, compared with a cure rate of only 40 percent in patients who got a four-drug combination.

The three drugs were rifabutin sold by Pharmacia & UpJohn under the brand name Mycobutin; ethambutol, also known as Myambutol and sold by Lederle, a unit of American Home Products; and clarithromycin, sold by Abbott Laboratories Inc under various names, including Biaxin and Klaricid.

The four-drug regimen that was far less effective consisted of clofizimine, sold by Ciba-Geigy as Lamprene; ciprofloxacin, sold under the brand name Cipro by Miles Pharmaceutical; rifampin, sold by Marion Merrell Dow under the brand name Rifadin, and ethambutol.

The research is the first time a combination treatment has been found to increase survival in AIDS patients, Horsburgh said in an editorial in the Journal.

In the second study, Dr. Mark Pierce of Vanderbilt University in Nashville and his colleagues in the United States and Europe found that regular use of clarithromycin tablets twice a day lowered the risk of infection from 16 percent, which was the rate among placebo recipients, to 6 percent for volunteers who got the drug.

All of the 667 volunteers in the study, conducted by a team that included four Abbott researchers, were in the advanced stages of AIDS.

The third study, led by Dr. Diane Havlir of the University of California at San Diego, looked at a different drug, azithromycin, and found that only 7.6 percent of the patients who took it once a week developed mycobacterium avium compared with 15.3 percent who took rifabutin.

Combining the drugs worked even better, producing an infection rate of only 2.8 percent. But the abdominal pain, diarrhea and nausea produced by the combination made the two-drug treatment significantly more unpleasant than the azithromycin therapy alone, the researchers said.

With the new findings, Horsburgh said, drug treatment designed to prevent Mycobacterium avium "should be considered the standard of care."

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