Table 3

Suggested antibiotic regimens for adults with M. avium complex-pulmonary disease

M. avium complex-pulmonary diseaseAntibiotic regimen
Non-severe MAC-pulmonary disease
(ie, AFB smear-negative respiratory tract samples, no radiological evidence of lung cavitation or severe infection, mild-moderate symptoms, no signs of systemic illness)
Rifampicin 600 mg 3× per week and Ethambutol 25 mg/kg 3× per week and Azithromycin 500 mg 3× per week or clarithromycin 1 g in two divided doses 3× per week Antibiotic treatment should continue for a minimum of 12 months after culture conversion.
Severe MAC-pulmonary disease (ie, AFB smear-positive respiratory tract samples, radiological evidence of lung cavitation/severe infection, or severe symptoms/signs of systemic illness)Rifampicin 600 mg daily and Ethambutol 15 mg/kg daily and Azithromycin 250 mg daily or clarithromycin 500 mg twice daily and consider intravenous amikacin for up to 3 months or nebulised amikacin Antibiotic treatment should continue for a minimum of 12 months after culture conversion.
Clarithromycin-resistant MAC-pulmonary diseaseRifampicin 600 mg daily and Ethambutol 15 mg/kg daily and Isoniazid 300 mg (+pyridoxine 10 mg) daily or moxifloxacin 400 mg daily and consider intravenous amikacin for up to 3 months or nebulised amikacin Antibiotic treatment should continue for a minimum of 12 months after culture conversion.