Evidence map›Paper›PMID 24457542›Full record

ArticleChest2014

Macrolide/Azalide therapy for nodular/bronchiectatic mycobacterium avium complex lung disease.

Richard J Wallace, Barbara A Brown-Elliott, Steven McNulty, Julie V Philley, Jessica Killingley, Rebecca W Wilson, Deanna S York, Sara Shepherd, David E Griffith

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Chest, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03672630 (Comparison of Two- Versus Three-antibiotic Therapy for Pulmonary Mycobacterium Avium Complex Disease), which is not on this map. Cited by 152 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 4 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03672630 phase2 / phase3completednot on this mapstarted 2019, after this paper: background citation

Comparison of Two- Versus Three-antibiotic Therapy for Pulmonary Mycobacterium Avium Complex Disease

TypeinterventionalSponsorKevin WinthropRan2019 to 2026Enrolled474ConditionsMycobacterium Avium Complex, Nontuberculous Mycobacterium InfectionArmsAzithromycin, Ethambutol, Rifampin
3 · Its place in the literature

Who cites it

152 citing papers in PubMed, 4 syntheses or guidelines pooled it.

  1. Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020
    Guideline
  2. Treatment of Nontuberculous Mycobacterial Pulmonary Disease: An Official ATS/ERS/ESCMID/IDSA Clinical Practice Guideline.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020
    Guideline
  3. Guideline
  4. Guideline
  5. Trial
  6. Intermittent versus Daily Therapy for NoncavitaryAnnals of the American Thoracic Society · 2025
    Trial
  7. Trial
  8. Trial
  9. Macrolide-resistantJournal of clinical tuberculosis and other mycobacterial diseases · 2026
    Review
  10. Article
  11. Article
  12. Understanding recurrence inJournal of clinical microbiology · 2026
    Review
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article

92 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Richard J WallaceDepartment of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX; Department of Microbiology, University of Texas Health Science Center at Tyler, Tyler, TX; Department of Pathology, University of Texas Health Science Center at Tyler, Tyler, TX.
Barbara A Brown-ElliottDepartment of Microbiology, University of Texas Health Science Center at Tyler, Tyler, TX; Department of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX.
Steven McNultyDepartment of Microbiology, University of Texas Health Science Center at Tyler, Tyler, TX.
Julie V PhilleyDepartment of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX.
Jessica KillingleyDepartment of Microbiology, University of Texas Health Science Center at Tyler, Tyler, TX.
Rebecca W WilsonDepartment of Pathology, University of Texas Health Science Center at Tyler, Tyler, TX.
Deanna S YorkDepartment of Microbiology, University of Texas Health Science Center at Tyler, Tyler, TX.
Sara ShepherdDepartment of Pathology, University of Texas Health Science Center at Tyler, Tyler, TX.
David E GriffithDepartment of Medicine, University of Texas Health Science Center at Tyler, Tyler, TX. Electronic address: david.griffith@uthct.edu.

Funding

TRAINING PROGRAM IN LUNG BIOLOGY AND DISEASET32HL098040 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI SHAUL, PHILIP W, TERADA, LANCE S · 2009 to 2024
$4.6M
NHLBI NIH HHS T32 HL098040
6 · The paper itself

Abstract

backgroundThere is no large study validating the appropriateness of current treatment guidelines for Mycobacterium avium complex (MAC) lung disease. This is a retrospective single-center review evaluating the efficacy of macrolide/azalide-containing regimens for nodular/bronchiectatic (NB) MAC lung disease.

methodsPatients were treated according to contemporary guidelines with evaluation of microbiologic responses. Macrolide susceptibility of MAC isolates was done at initiation of therapy, 6 to 12 months during therapy, and on the first microbiologic recurrence isolate. Microbiologic recurrence isolates also underwent genotyping for comparison with the original isolates.

resultsOne hundred eighty patients completed > 12 months of macrolide/azalide multidrug therapy. Sputum conversion to culture negative occurred in 154 of 180 patients (86%). There were no differences in response between clarithromycin or azithromycin regimens. Treatment regimen modification occurred more frequently with daily (24 of 30 [80%]) vs intermittent (2 of 180 [1%]) therapy (P = .0001). No patient developed macrolide resistance during treatment. Microbiologic recurrences during therapy occurred in 14% of patients: 73% with reinfection MAC isolates, 27% with true relapse isolates (P = .03). Overall, treatment success (ie, sputum conversion without true microbiologic relapse) was achieved in 84% of patients. Microbiologic recurrences occurred in 74 of 155 patients (48%) after completion of therapy: 75% reinfection isolates, 25% true relapse isolates.

conclusionsCurrent guidelines for macrolide/azalide-based therapies for NB MAC lung disease result in favorable microbiologic outcomes for most patients without promotion of macrolide resistance. Intermittent therapy is effective and significantly better tolerated than daily therapy. Microbiologic recurrences during or after therapy are common and most often due to reinfection MAC genotypes.

Indexed as

AgedAnti-Bacterial AgentsAzithromycinBronchiectasisClarithromycinDNA, BacterialDose-Response Relationship, DrugDrug Administration ScheduleDrug Therapy, CombinationElectrophoresis, Gel, Pulsed-FieldFemaleFollow-Up StudiesGenotypeHumansLung DiseasesMacrolidesAnti-Bacterial AgentsAzithromycinClarithromycinDNA, BacterialMacrolides

Identifiers

PMID24457542
PMCPMC4694082

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.