Mycobacterium avium Complex (MAC)

November 2004     View PDF     En español

1999 Public Health Service
Prevention Guidelines on MAC Prevention:

Preventive

• MAC therapy is needed for adults with CD4+ cell counts below 50.
• First choice: clarithromycin or azithromycin; second choice: rifabutin.
• Before starting preventive therapy, rule out active MAC or TB infection.
• Check for potential drug interactions.

Maintenance

• Clarithromycin or azithromycin plus ethambutol and with or without rifabutin.

Prevention in children

• Clarithromycin or azithromycin are the drugs of choice for children:
  
  Over 6 years, CD4+ cells below 50;
  2-6 years, CD4+ cells below 75;
  1-2 years, CD4+ cells below 500;
  Less than 12 months, CD4+ cells below 750.

Prevention during pregnancy.

• MAC preventive therapy is needed for pregnant women with CD4+ cell counts less than 50.
• Azithromycin is the drug of choice.