Azithromycin-containing regimens for treatment of Mycobacterium avium complex lung disease

Ninety-two patients were assessable in 3 consecutive, open, noncomparative, prospective, controlled, single-center trials of the use of multidrug regi mens that contain azithromycin for treating pulmonary Mycobacterium avium c omplex (MAC) disease. Azithromycin was provided at a dose of 300-600 mg per day with oral companion drugs administered daily (regimen A, 29 patients); 600 mg 3 times weekly (t.i.w.), with oral companion drugs administered dai ly (regimen B, 20 patients); and 600 mg t.i.w., with oral companion drugs a dministered t.i.w. (regimen C, 43 patients). All regimens included rifabuti n (or rifampin) and ethambutol as companion drugs as well as initial strept omycin. Treatment success was defined as 12 months of negative cultures whi le on therapy. Treatment failure was defined as sputum culture positivity a fter at least 6 months of therapy. Of the patients in each regimen who reac hed study end points, 17 of 29 (59%) were in regimen A, 11 of 20 (55%) were in regimen B, and 28 of 43 (65%) were in regimen C met the treatment succe ss criterion. There were no statistically significant differences in outcom e between the 3 regimens. These studies demonstrate the effectiveness of da ily and t.i.w. regimens containing azithromycin for treatment of MAC lung d isease.