Effects of MAC Preventive Therapy on Disease-Causing Bacteria in HIV-Infected Patients: A Substudy of CPCRA 048 - Article
Clinical Trial: Effects of MAC Preventive Therapy on Disease-Causing Bacteria in HIV-Infected Patients: A Substudy of CPCRA 048
This study is no longer recruiting patients.
Some people who have taken azithromycin to prevent MAC (Mycobacterium avium Complex, a bacterial infection common in HIV-infected persons) have been found to carry antibiotic-resistant bacteria (germs that grow despite the presence of drugs used to kill them). The purpose of this study is to see if people who take azithromycin carry more antibiotic-resistant bacteria than people who have chosen to delay MAC preventive therapy. When bacteria like Streptococcus (a type of bacteria that causes pneumonia and meningitis) are frequently exposed to antibiotics, the bacteria can become resistant to the drugs. MAC preventive therapy uses antibiotics, but this can make it difficult to treat other infections caused by bacteria that have become resistant in HIV-infected persons. If MAC preventive therapy is delayed, Streptococcus in the body may be less likely to develop resistance. Therefore, if the patient does get a Streptococcus infection, it will be easier to treat because it is not resistant to the antibiotics.
|Mycobacterium avium-intracellulare Infection |
MedlinePlus related topics: AIDS; Bacterial Infections; Streptococcal Infections; Throat Disorders
Study Type: Observational
Study Design: Natural History
Official Title: Effects of Prophylaxis for Disseminated Mycobacterium Avium Complex (MAC) Disease with Azithromycin Versus Deferred Prophylaxis on Carriage of Antibiotic-Resistant Streptococcus pneumoniae: A Substudy of the CR-MAC Protocol (CPCRA 048)
Expected Total Enrollment: 450
Streptococcus pneumoniae is a leading cause of bacteremia, pneumonia, meningitis, and otitis media in the United States. Prior to 1987, this organism was uniformly susceptible to penicillin; since then, however, increasing numbers of isolates resistant to penicillin, as well as to other common antibiotics, have been identified. Frequent exposure to antibiotics has been documented as an important risk factor for the emergence of resistant organisms in HIV-infected patients, who are more likely than uninfected people to be colonized with antibiotic-resistant strains of S. pneumoniae. This substudy is the first to examine the effects of withdrawing or delaying the initiation of prophylaxis (in this case, MAC prophylaxis) on the prevalence of antibiotic-resistant pneumococci in a prospective manner.
Study participants are a subset of those enrolled in the CR-MAC Protocol (CPCRA 048). Oropharyngeal swabs are taken at baseline and 4 months after randomization, and are used to isolate S. pneumoniae in culture. These isolates are tested for susceptibility to macrolides, penicillin, cephalosporins, quinolones, and TMP-SMX. The rates of pneumococcal colonization at baseline and 4 months after randomization are determined and used to estimate the impact of deferring MAC prophylaxis on carriage of antibiotic-resistant S. pneumoniae.
Ages Eligible for Study: 18 Years and above, Genders Eligible for Study: Both
You may be eligible for this study if you:
- Are enrolled in CPCRA 048.
Community Consortium / UCSF, San Francisco, California, 94110, United States
Denver CPCRA / Denver Public Hlth, Denver, Colorado, 802044507, United States
District of Columbia
Washington Reg AIDS Prog / Dept of Infect Dis, Washington, District of Columbia, 20422, United States
AIDS Research Consortium of Atlanta, Atlanta, Georgia, 303081962, United States
AIDS Research Alliance - Chicago, Chicago, Illinois, 60657, United States
Louisiana Comm AIDS Rsch Prog / Tulane Univ Med, New Orleans, Louisiana, 70112, United States
Henry Ford Hosp, Detroit, Michigan, 48202, United States
Wayne State Univ - WSU/DMC / Univ Hlth Ctr, Detroit, Michigan, 48201, United States
North Jersey Community Research Initiative, Newark, New Jersey, 071032842, United States
Southern New Jersey AIDS Cln Trials / Dept of Med, Camden, New Jersey, 08103, United States
Partners in Research / New Mexico, Albuquerque, New Mexico, 87131, United States
Harlem AIDS Treatment Grp / Harlem Hosp Ctr, New York, New York, 10037, United States
The Research and Education Group, Portland, Oregon, 97210, United States
Philadelphia FIGHT, Philadelphia, Pennsylvania, 19107, United States
Richmond AIDS Consortium / Div of Infect Diseases, Richmond, Virginia, 232980049, United States
El-Sadr W, Study Chair
Burman W, Study Chair
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El-Sadr WM, Manneheimer S, Grant L, Matts J. Use of PCP and MAC prophylaxis among eligible patients with and without CD4+ rebound. 39th Intersci Conf Antimicrob Agents Chemother. 1999 Sept 26-29 (abstract no 129)
Record last reviewed: August 2004
Last Updated: April 7, 2005
Record first received: November 2, 1999
ClinicalTrials.gov Identifier: NCT00000933
Health Authority: United States: Federal Government
ClinicalTrials.gov processed this record on 2005-04-08
Cache Date: April 9, 2005
- Vancomycin-Intermediate/Resistant Staphylococcus aureus(VISA/VRSA) Infections (Centers for Disease Control and Prevention)