PT  - JOURNAL ARTICLE
AU  - David Griffith
AU  - Barbara Brown-Elliott
AU  - Sara Shepherd
AU  - Julie Philley
AU  - Richard Wallace
TI  - Therapeutic outcomes for cavitary <em>Mycobacterium avium</em> complex (MAC) lung disease
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - P4372
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/P4372.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/P4372.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Beginning in 1992, patients were enrolled in a series of prospective clinical trials investigating the safety and efficacy of 3 or 4 drug macrolide-containing regimens for treating cavitary MAC lung disease. Based on these studies subsequent MAC lung disease patients received similar regimens. All patients were diagnosed according to contemporary nontuberculous mycobacterial (NTM) diagnostic guidelines. Patients are included in this analayis only if they had a macrolide susceptible MAC isolate prior to initiation of therapy and subsequently tolerated a 3 to 4 drug regimen consisting of macrolide, ethambutol, and a rifamyicn (rifampin or rifabutin) ± injectable agent (streptomycin or amikacin) administered daily or three times weekly. There were 240 patients in the intent to treat analysis with a mean age 63.2 ± 12.4 years (range 35-90 years) who were 76% male, 80% white and 75% current or exsmokers (≥ 10 pack years smoking). 134 patients had adequate records available for treatment outcome evaluation. 86/134 (64%) had sputum AFB culture conversion while on therapy. Over the study period, the all cause mortality was 57% for the intent to treat cohort and 41% for patients with sputum AFB culture conversion on therapy. We conclude that cavitary MAC lung disease can be effectively treated with macrolide-based regimens but is associated with high all cause mortality regardless of MAC treatment response.Funded in part by the Amon Carter Foundation, Ft. Worth, TX and W.A. and E.B. Moncrief Distinguished Professorship UTHSCT.