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Antimicrobials during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Clarithromycin (Biaxin) belongs to the macrolide group of antibiotics. Although it is effective against a wide variety of aerobic organisms, it is most commonly used for treatment or prophylaxis against Mycobacterium avium complex (MAC) in patients who are human immunodeficiency virus (HIV)-positive. It also has good activity against Ureaplasma urealyticum (Reisner, 1996). The manufacturer lists the drug as a category C drug. In one large population-based study, 686 women used clarithromycin during the first trimester, and the frequency of birth defects was not increased (Muanda et al., 2017).
Substance Use Disorder, Intentional Self-Harm, Gun Violence, and HIV/AIDS
Published in Amy J. Litterini, Christopher M. Wilson, Physical Activity and Rehabilitation in Life-threatening Illness, 2021
Amy J. Litterini, Christopher M. Wilson
Individuals with advanced stage disease of AIDS may present with several reasons for referral for palliative care, and with a six-month prognosis, for hospice care. Some will experience AIDS-related cancers such as central nervous system (CNS) lymphoma, Kaposi’s sarcoma, and/or systemic lymphoma. Other conditions associated with advanced AIDS include: refractory cachexia; opportunistic infections (e.g. mycobacterium avium complex [MAC], cryptosporidium, cytomegalovirus, toxoplasmosis); renal failure; congestive heart failure; advanced AIDS dementia complex; and progressive multifocal leukoencephalopathy. Eligibility for hospice care for individuals with HIV/AIDS in the United States includes consideration of CD4/viral load levels, concurrently with one of the previously listed conditions associated with advanced disease.67 Additionally, a Karnofsky Performance Status of <50 also meets hospice eligibility criteria. An interdisciplinary team is needed to manage the multifaceted presentation of advanced AIDS disease. Addressing end-of-life symptoms with a holistic approach can provide for the most peaceful outcomes possible.
The NHO Medical Guidelines for Non-Cancer Disease and Local Medical Review Policy: Hospice Access for Patients with Diseases Other Than Cancer
Published in Inge B. Corless, Zelda Foster, The Hospice Heritage: Celebrating Our Future, 2020
In addition, they should have a decreased functional status corresponding to less than or equal to 50 on the Karnofsky Performance Status (KPS) scale, as well as at least one of the following AIDS-related conditions: Central nervous system or poorly responsive systemic lymphoma.Wasting: loss of more than thirty-three percent of lean body mass.Mycobacterium avium complex (MAC) bacteremia.Progressive multifocal leukoencephalopathy (PML).Refractory visceral Kaposi’s sarcoma (KS).Renal failure in the absence of dialysis.Refractory cryptosporidium infection.Refractory toxoplasmosis.
Health state utility estimation of Mycobacterium avium complex pulmonary disease using a time trade-off approach
Published in Journal of Medical Economics, 2023
Tatsunori Murata, Kozo Morimoto, Fujio Matsuyama, Mayumi Yamada, Joseph Feliciano, Mariam Hassan
Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a rare, progressive, and sometimes life-threatening pulmonary disorder that is increasing in prevalence and incidence worldwide.1–4 In Japan, NTM-PD incidence increased 2.6 fold from 2007 (5.7 cases/100,000 person-years) to 2014 (14.7 cases/100,000 person-years).5 The prevalence of NTM-PD in Japan has been estimated to be up to 10 times the incidence, as a consequence of the intractable nature of the disease.6Mycobacterium avium complex pulmonary disease (MAC-PD), typically the result of infection with either Mycobacterium avium or Mycobacterium intracellulare, is the most common form of NTM-PD, accounting for 80–90% of NTM-PD cases in Japan.2,7,8
Investigation of drug regimens and treatment outcome in patients with Mycobacterium Simiae: a systematic review
Published in Expert Review of Anti-infective Therapy, 2022
Shirin Dashtbin, Shiva Mirkalantari, Masoud Dadashi, Davood Darban-Sarokhalil
The Infectious Diseases Society of America (IDSA), American Thoracic Society (ATS), European Society of Clinical Microbiology and Infectious Diseases (ESCMID), and European Respiratory Society (ERS) have jointly developed a guideline to update the treatment recommendations for nontuberculous mycobacterial (NTM) pulmonary infection in adults [8]. This guideline suggests an antibiotic regimen for M. simiae infections similar to that for Mycobacterium avium complex (MAC) infections [8]. IDSA recommends a macrolide-based treatment regimen together with moxifloxacin, clofazimine, and streptomycin or amikacin for the treatment of M. simiae infections. Other macrolide-based regimens, such as a combination of clarithromycin with fluoroquinolones and trimethoprim/sulfamethoxazole may be also be recommended for M. simiae infections. In previous studies, macrolides, such as clarithromycin, combined with quinolones, such as moxifloxacin, together with TMP/SMX, had the most significant effect on eliminating the clinical signs of M. simiae pulmonary infection. All patients survived after the anti-TB combination therapy together with clarithromycin, moxifloxacin, ciprofloxacin, and amikacin. Similar to most NTMs, the majority of M. simiae isolates have resistance to the first-line antimycobacterial medications, such as isoniazid, ethambutol, and rifampicin [8].
A multidisciplinary approach to the management of nontuberculous mycobacterial lung disease: a clinical perspective
Published in Expert Review of Respiratory Medicine, 2021
Nontuberculous mycobacteria (NTM) are ubiquitous environmental organisms that can colonize in the airways to cause a complex, chronic pulmonary disease that is not only difficult to manage but also often refractory to treatment [1–4]. Mycobacterium avium complex (MAC) is the NTM pathogen most commonly associated with lung disease. Symptoms of NTM lung disease (NTM-LD) include chronic cough, sputum production, hemoptysis, fatigue, malaise, and weight loss. These symptoms are nonspecific and are shared with those of other pulmonary diseases such as tuberculosis, bronchiectasis, emphysema, chronic obstructive pulmonary disease (COPD), and cystic fibrosis (CF) [4–7]. Diagnosis of NTM-LD is complex, requiring careful evaluation of clinical, microbiological, and radiographic features along with the exclusion of other disorders [6–9].