TY - JOUR T1 - Therapeutic outcomes for cavitary <em>Mycobacterium avium</em> complex (MAC) lung disease JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P4372 AU - David Griffith AU - Barbara Brown-Elliott AU - Sara Shepherd AU - Julie Philley AU - Richard Wallace Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P4372.abstract N2 - 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. ER -