TREATMENT OF NONTUBERCULOUS MYCOBACTERIAL INFECTIONS - ROLE OF CLARITHROMYCIN AND AZITHROMYCIN

The incidence of identification of nontuberculous mycobacteria has inc reased since the advent of the acquired immunodeficiency syndrome epid emic. Although Mycobacterium avium complex appears to be responsible f or most episodes of nontuberculous disease, several other previously r are species are increasingly being detected, including Mycobacterium k ansasii, Mycobacterium fortuitum/chelonei complex, and Mycobacterium g enavense. This review briefly summarizes the epidemiology and clinical features of these infections, as well as therapeutic and preventive s trategies in immunosuppressed patients with nontuberculous mycobacteri al infections. Of clinical relevance, nontuberculous mycobacterial inf ections are difficult to treat and do not respond to traditional antit uberculous agents. The search for more effective treatment regimens is ongoing in an attempt to enhance survival and reduce morbidity among immunocompromised patients. Novel antimicrobial combinations that incl ude clarithromycin or azithromycin have been shown to be effective in treating several nontuberculous mycobacterial infections.