Patients were classified into two groups: the REM group and the REMAC group. A waiver from the local ethical board has been given for this retrospective study. We conducted a retrospective cohort study of adults (>18 years) with macrolide-susceptible MAC-PD diagnosed according to current guidelines, treated from January 2007 until January 2017 in our reference clinic (last check: March 2021). Here, we evaluate its outcome, as compared to a cohort that only received the REM regimen. In our nontuberculous mycobacterium (NTM) reference clinic, patients with severe MAC-PD have been receiving intensified treatment with the REMAC regimen since 2013. In retrospective studies, the outcomes of treatment regimens in which clofazimine replaces rifamycin are similar to those of the recommended REM regimen. In vitro, clofazimine shows synergy with amikacin and macrolides against MAC. Ĭlofazimine (C), an old anti-leprosy drug, may add efficacy to MAC-PD treatment regimens. In severe disease, amikacin (A) can be added to improve treatment outcome, but there is no direct evidence to support its role. ![]() The currently recommended treatment for MAC-PD is a combination of a rifamycin (R), ethambutol (E) and a macrolide (M), preferably azithromycin. ![]() Reported cure rates vary by disease manifestation, with poorest cure rates in fibrocavitary disease. Treatment of MAC-PD is difficult due to its long duration, frequent adverse events and comorbidities of the host. Mycobacterium avium, Mycobacterium intracellulare, Mycobacterium chimaera and related species, can cause severe pulmonary disease (MAC-PD), especially in patients with chronic pulmonary diseases, like COPD and bronchiectasis. Mycobacterium avium complex (MAC) bacteria, i.e.
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