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Free Content Efficacy and outcomes of clarithromycin treatment for pulmonary MAC disease

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SETTING: Retrospective review of patients with pulmonary Mycobacterium avium complex (MAC) disease treated with clarithromycin.

OBJECTIVES: To investigate whether the short-term response to treatment predicts long-term outcomes, and to analyse what explanatory variables are associated with the efficacy and outcome of treatment.

DESIGN: Sputum conversion rates in short- and long-term outcomes were evaluated for 111 patients. Respectively 9 and 10 explanatory variables were analysed for their association with both response and outcomes.

RESULTS: Eighty-four patients (75.7%) showed good short-term response and 94 (82.0%) showed good long-term outcomes. Women and patients with satisfactory nutrition status showed good short-term response. Patients with small lesions and those treated for >12 months after sputum conversion showed good long-term outcomes. Patients who showed good short-term response, in the group with large lesions, showed significantly good long-term outcomes (P = 0.0382).

CONCLUSION: There were differences between prognostic factors reflecting short-term response and long-term outcomes. The short-term response predicts long-term outcomes in certain groups divided by prognostic factor. To establish standard treatment for pulmonary MAC disease, it is important to determine a standardised method of evaluation of treatment taking such factors into consideration.
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Keywords: MAC; clarithromycin; efficacy; outcomes; pulmonary disease; treatment

Document Type: Regular Paper

Affiliations: Department of Respiratory Medicine, Dohoku National Hospital, Asahikawa, Japan

Publication date: 2005-11-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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