@carolj68 I am curious about your drug regimen: rifampin, ethambutol, clofazimine and azithromycin daily. I have been reading about clofazimine as a potential replacement for amikacin but in your case it seemed you needed the amikacin to convert. Can you speak to your use of clofazimine? Was it included with the initial Big 3 treatment in hopes of converting without Amikacin? I read a study just last night that replaced rifampin with clofazimine in harder to treat patients (cavitary, advanced disease) but your doctor seemed to add it to the Big 3, like they do with Amikacin. I am just learning about clofazimine and trying to get a better understanding of its use with MAC. I have cavitary disease and I understand that while some ID doctors are starting to drop rifampin (and there is study done but I don’t think results out yet on just two drugs for non-cavitary disease) with cavity disease a third drug is still felt necessary, raising the obvious next question of options for this third drug. Amikacin seems an obvious choice but its known toxity levels seem to preclude long term use for many. I recently read that there is a clinical trial underway studying clofazimine for treating MAC but I don’t have any details in terms of the when/how of its tested use. My understanding is that it’s being looked at as a less toxic alternative to amikacin. I think we could all get behind a less toxic option to amikacin.

Anyone that has experience with clofazimine I would be interested in hearing about it. How was it part of your drug protocol and what was your experience.

Thanks!