Table 3.

Suggested antibiotic regimens for adults with Mycobacterium avium complex (MAC)-pulmonary disease

MAC-pulmonary disease	Antibiotic regimen
Non-severe MAC-pulmonary disease (ie, AFB smear negative respiratory tract samples, no radiological evidence of lung cavitation or severe infection, mild-to-moderate symptoms, no signs of systemic illness)	Rifampicin 600 mg 3×per week and Ethambutol 25 mg/kg 3×per week and Azithromycin 500 mg 3×per week or Clarithromycin 1 g in two divided doses 3 x per week. Antibiotic treatment should continue for a minimum of 12 months after culture conversion.
Severe MAC-pulmonary disease (ie, AFB smear positive respiratory tract samples, radiological evidence of lung cavitation/severe infection, or severe symptoms/signs of systemic illness)	Rifampicin 600 mg daily and Ethambutol 15 mg/kg daily and Azithromycin 250 mg daily or Clarithromycin 500 mg twice daily and Consider intravenous amikacin for up to 3 months or nebulised amikacin. Antibiotic treatment should continue for a minimum of 12 months after culture conversion.
Clarithromycin-resistant MAC-pulmonary disease	Rifampicin 600 mg daily and Ethambutol 15 mg/kg daily and Isoniazid 300 mg (+pyridoxine 10 mg) daily or moxifloxacin 400 mg daily and Consider intravenous amikacin for up to 3 months or nebulised amikacin. Antibiotic treatment should continue for a minimum of 12 months after culture conversion.

AFB, acid-fast bacilli; NTM, non-tuberculous mycobacteria.