Azithromycin: A promising treatment option for Mycobacterium avium complex pulmonary disease in case of intolerance to clarithromycin

Macrolide-based combination chemotherapy is recommended for the treatment of Mycobacterium avium complex (MAC) pulmonary disease (MPD). The susceptibility of the MAC to macrolide antibiotics (MAs) determines the efficacy of treatment and clinical course of MPD. However, MAs cause several adverse effects, resulting in the discontinuation of macrolide-based combination chemotherapy. We encountered two women aged 65 years and 66 years diagnosed with MPD based on bronchoscopic examinations. They were initially treated with clarithromycin-based combination chemotherapy. However, neither patient could continue with chemotherapy owing to adverse events such as rash and edema. We switched clarithromycin with azithromycin, and the patients were able to continue chemotherapy without adverse events. Both patients completed their treatment successfully. Azithromycin, which also belongs to the class of MAs, can be a promising therapeutic option for MPD in case of clarithromycin intolerance.