Treatment of disseminated Mycobacterium avium complex infection in AIDS with amikacin, ethambutol, rifampin, and ciprofloxacin

In the United States, the most common type of mycobacterial infection in patients with AIDS is disseminated or widespread Mycobacterium avium complex infection. This infection is associated with bacteremia, or infection of the blood, and symptoms of weight loss, night sweats, chills, diarrhea, and fever. Agents commonly used to treat tuberculosis, an infectious disease caused by Mycobacterium tuberculosis, are ineffective in treating M. avium complex infection. The effects of combined treatment with the antibiotics amikacin, ethambutol, rifampin, and ciprofloxacin were assessed in 17 AIDS patients with disseminated M. avium complex infection. Amikacin was administered intravenously for 4 weeks and the remaining antibiotics were taken by mouth for 12 weeks. Fifteen patients completed at least four weeks of drug therapy. The combined antibiotic regimen decreased the colony count, or number of bacteria in the blood, from 537 per milliliter (mL) to 14 per mL after four weeks of treatment. The decrease in numbers of bacteria was maintained during drug treatment and was associated with an improvement in the symptoms of M. avium complex infection. Seven of 17 patients discontinued drug treatment early, at less than 12 weeks, due to gastrointestinal intolerance and adverse effects on the liver. These findings demonstrate that the combined antibiotic regimen of amikacin, ethambutol, rifampin, and ciprofloxacin is effective in decreasing bacterial numbers and symptoms associated with M. avium complex infection in patients with AIDS. (Consumer Summary produced by Reliance Medical Information, Inc.)