Pulmonary or disseminated disease: |
M avium complex (MAC) | Rifampicin 450 or 600 mg orally once daily (or rifabutin 300 mg once daily), ethambutol 15 mg per kg orally once daily, and clarithromycin 500 mg orally b.d. | |
M kansasii
| Lifelong |
M malmoense
| |
M xenopi
| |
Prophylaxis against MAC: |
1st choice | Azithromycin 1200 mg orally weekly | Indefinitely |
2nd choice | Clarithromycin 500 mg orally b.d. | Indefinitely |
3rd choice | Azithromycin 1200 mg orally weekly | |
| + | |
| Rifabutin 300 mg orally once daily. | Indefinitely |
Drug interactions in HIV positive patients: |
Rifabutin + clarithromycin | Uveitis |
Rifabutin + fluconazole | Greatly reduces fluconazole levels |
Rifampicin } + protease | Decrease in serum level of protease inhibitors, increase in serum level of |
Rifabutin inhibitors | rifampicin and rifabutin |