Table 4

Recommended regimens for HIV positive patients with disease due to opportunist mycobacteria

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 choiceAzithromycin 1200 mg orally weeklyIndefinitely
 2nd choiceClarithromycin 500 mg orally b.d.Indefinitely
 3rd choiceAzithromycin 1200 mg orally weekly
Rifabutin 300 mg orally once daily.Indefinitely
Drug interactions in HIV positive patients:
Rifabutin + clarithromycinUveitis
 Rifabutin + fluconazoleGreatly reduces fluconazole levels
 Rifampicin } + proteaseDecrease in serum level of protease inhibitors, increase in serum level of
 Rifabutin    inhibitorsrifampicin and rifabutin