Mycobacterium avium Complex (MAC)

November 2004     View PDF     En español

Children

Children with advanced HIV have a high risk of developing disseminated MAC. It is recommended that preventive MAC therapy with azithromycin (20mg/kg once a week, max. 1,200mg/day) or clarithromycin (7.5mg/kg twice a day, max. 1,000mg/day) be started in children in the following categories:

     Older than six years, CD4+ cells below 50
     Two to six years old, CD4+ cells below 75
     One to two years old, CD4+ cells below 500
     Less than twelve months old, CD4+ cells below 750

Azithromycin and clarithromycin are both available as a liquid for children. A solution of rifabutin can be made by a pharmacist using the powder from capsules. There have not been any studies on the safety of stopping MAC prevention in children whose CD4+ cell counts have increased due to potent anti-HIV therapy.

The guidelines for treating children with MAC are the same as those for adults. To stop MAC returning in children, they should take the following maintenance therapy: clarithromycin (30mg/kg per day in two doses) plus at least one of ethambutol (15mg/kg once a day) and rifabutin (5mg/kg once a day).