MAC Prophylaxis
Posted: May 29, 2003
QUESTION:
I am a pharmacist and I run an HIV program in my pharmacy. I have a patient who 6 months ago had a CD-4 count of 35 and was started on Kaltera and Combivir, along with dapsone 100mg QD and zithromax 1200mg Q week. He was complaining of nausea and vomiting every sunday thru tuesday. The physician and I came to the conclusion it was the zithromax. The patient now has had a CD-4 count of 135 atleast for a month now. My question is, do you think it is okay to stop the azithromycin now, or just treat the nausea with prochlorperazine or ondansetron for another couple of months before discontinuing the azithromycin??
Thank you,
Michael Nunes, PharmD
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RESPONSE FROM: 
With a CD4 count that is greater than 100, particularly if the viral load is undetectable and CD4 is rising, I'd think that stopping MAC primary prophylaxis would be very reasonable, particulary in someone with ongoing side effects of MAC prophylaxis (nausea,vomiting). BY
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