RANDOMIZED, PLACEBO-CONTROLLED TRIAL OF RIFAMPIN, ETHAMBUTOL, AND CIPROFLOXACIN FOR AIDS PATIENTS WITH DISSEMINATED MYCOBACTERIUM-AVIUM COMPLEX INFECTION

Patients with AIDS and disseminated Mycobacterium avium complex (MAC) infection received rifampin (600 mg) plus ethambutol (25 mg/kg) plus ciprofloxacin (750 mg) or matching placebos daily for 8 weeks. Patients were monitored every 2 weeks clinically and by quantitating MAC colony-forming units (cfu) per milliliter of blood. Analysis of baseline characteristics revealed no significant differences between groups. After 8 weeks, MAC cfu had decreased by greater-than-or-equal-to 1 log/mL in 4 of 9 treated patients versus 0 of 10 placebo recipients while increasing by greater-than-or-equal-to 1 log/mL in 1 and 7, respectively (P = .006). While the average combined clinical response score declined in both groups, it tended to decrease less in treated patients (P = .36). On the other hand, dose-limiting toxicity (primarily nausea and adverse drug interactions) occurred in 9 of 12 treatment versus 1 of 12 placebo patients (P = .005). Combined rifabutin-ethambutol-ciprofloxacin therapy for disseminated MAC infection had significant microbiologic efficacy with some evidence of clinical efficacy but was associated with drug intolerance.