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participating institutions:
Johns Hopkins University AIDS Service, New York State DOH AIDS Institute, The CORE Center, Cook County Hospital



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Clarithromycin or Rifabutin alone or in Combination for Primary Prophylaxis of Mycobacterium Avium Complex Disease in Patients with AIDS: A Randomized, Double-Blind, Placebo-Controlled Trial [Benson CA, et al. JID 2000;181:1289]: This is a CPCRA collaborative study of M. avium prophylaxis in 1,178 patients with CD4 cell counts <100/mm3 who were randomized to receive clarithromycin, rifabutin, or both. The results with clarithromycin were significantly better than with rifabutin (p = 0.005), and clarithromycin plus rifabutin was not significantly better than clarithromycin alone.
Comment: We have known about this study for over three years since it was presented at the 1996 Retrovirus Conference in Washington [Abstract 205]. It is regarded as a pivotal study in terms of the current USPHS/IDSA guidelines for MAC prophylaxis. The presumed reason for the lack of added benefit with rifabutin added to clarithromycin is a drug interaction resulting in reduced levels of clarithromycin. posted 7/5/2000







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