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Progress report: prophylaxis and therapy for MAC.


 Study efforts are showing progress in the prevention and therapy of Mycobacterium avium complex (MAC) infection. A review of recent study developments highlights clinical findings on prophylactic use of rifabutin, clarithromycin, and azithromycin, used both as monotherapies and as combination therapies. Three tables highlight study results from MAC prophylaxis studies, MAC treatment studies, and candidate regimens for MAC prophylaxis in AIDS. Treatment of disseminated MAC is also addressed. The combination of clarithromycin and clofazimine should not be used as initial therapy. Clofazimine's role in initial therapy is uncertain, and combinations of clarithromycin and ethambutol, with or without rifabutin, appear to be the best current treatment options.
