Treatment strategies for Mycobacterium avium pulmonary disease

Macrolides are known to play a key role in the treatment of nontuberculous mycobacteria. However, the optimal combination and number of drugs remains uncertain. N agawawa et al. and Z weijpfenning et al. investigated these questions in two randomised controlled trials exploring treatment regimens for Mycobacterium avium complex (MAC) infections, while N guyen et al . summarised some of these questions in a meta-analysis. N agawawa et al. compared an intermittent three-drug regimen to daily therapy, while Z weijpfenning et al. compared rifampicin or clofazimine as adjuncts to ethambutol and a macrolide. Tolerance levels for intermittent therapy were not significantly superior to those of daily therapy, while a clofazimine–ethambutol–macrolide regimen was non-inferior to one including rifampicin. Finally, N guyen et al . conclude that a two-drug regimen may be a viable option for treating MAC infections.