Rifabutin in the Treatment of Mycobacterium avium Complex Infection: Experience in Europe

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Abstract
Several European clinical trials of rifabutin alone or in multidrug regimens for treatment of infections due to Mycobacterium avium complex (MAC) in patients with AIDS are discussed. A prospective open study in France assessed 50 patients treated with the combination rifabutin/ isoniazid/ethambutol/clofazimine. Treatment was well tolerated, and the rate of conversion of cultures (from positive to negative) was 70% at 6 months. A randomized, double-blind, placebo-controlled, prospective trial (the NTMT01 trial) assessed the role of rifabutin in treatment with a combination containing clofazimine, isoniazid, and ethambutol. The culture conversion rate was 74% for the rifabutin group and 53% for the placebo group at the last valid observation for evaluable patients. In the ongoing Curavium study, patients are receiving clarithromycin plus either clofazimine or both rifabutin and ethambutol. Treatment of MAC disease in patients with AIDS requires a combination of drugs, and available results indicate that rifabutin can be used safely in multidrug regimens.

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