Richard A. Chaisson; Constance A. Benson
Chaisson R., Benson C.; Clarithromycin Therapy for Mycobacterium avium Complex Bacteremia. Ann Intern Med. 1995;123:154-155. doi: 10.7326/0003-4819-123-2-199507150-00016
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Published: Ann Intern Med. 1995;123(2):154-155.
Drs. Singh and Yu wonder whether the increased prevalence of gastrointestinal symptoms and worse survival in patients randomly assigned to receive clarithromycin, 2000 mg twice daily, could reflect undiagnosed adrenal insufficiency. We do not believe that the gastrointestinal toxicity observed in the high-dose clarithromycin arm was a result of adrenal insufficiency. Patients were randomly assigned to one of three treatment arms, and we did not observe significant imbalances in patient characteristics by treatment. Gastrointestinal toxicity is a well-known, dose-related complication of macrolide therapy. Earlier studies of high-dose clarithromycin in patients with HIV infection confirmed the higher incidence of these effects in doses of 2000 mg or 3000 mg twice daily . As noted in our article, we could not attribute the differences in mortality to any one factor.
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