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Mononuclear and polymorphonuclear leukocyte dispositions of clarithromycin and azithromycin in AIDS patients

K Q Bui1, J McNabb, C Li

  • 1Department of Pharmacy Research, Division of Infectious Diseases, Hartford Hospital, Hartford, Connecticut 06102, USA.

Antimicrobial Agents and Chemotherapy
|September 3, 1999
PubMed

Insights

This study examined clarithromycin and azithromycin concentrations in immune cells of AIDS patients. Both antibiotics maintained high levels in cells, supporting their effectiveness for Mycobacterium avium complex (MAC) prophylaxis.

Area of Science:

  • Pharmacology
  • Infectious Diseases
  • Immunology

Background:

  • Mycobacterium avium complex (MAC) is an opportunistic infection in AIDS patients.
  • Prophylaxis is crucial to prevent MAC dissemination in immunocompromised individuals.
  • Clarithromycin and azithromycin are key agents for MAC prophylaxis.

Purpose of the Study:

  • To investigate the intracellular disposition of clarithromycin and azithromycin.
  • To compare drug concentrations in different leukocyte types in AIDS patients.
  • To correlate intracellular drug levels with efficacy for MAC prophylaxis.

Main Methods:

  • Studied intracellular drug concentrations of clarithromycin and azithromycin.
  • Analyzed drug levels in mononuclear and polymorphonuclear leukocytes.
  • Measured drug concentrations in AIDS patients undergoing MAC prophylaxis.

Main Results:

  • Significant differences observed in the intracellular disposition of clarithromycin and azithromycin.
  • Both drugs achieved sustained intracellular concentrations.
  • Concentrations exceeded the minimum inhibitory concentrations (MICs) for MAC throughout dosing periods.

Conclusions:

  • The distinct intracellular dispositions of clarithromycin and azithromycin were elucidated.
  • Sustained intracellular drug levels support the clinical efficacy of these antibiotics for MAC prophylaxis.
  • Findings reinforce the use of clarithromycin and azithromycin in AIDS patients at risk for MAC.

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