MAC Treatment: Rifampin vs Clofazimine

Posted by wolfplanetzero @wolfplanetzero, Jul 28, 2025

In a recent scholarly article, the author, a pulmonologist from South Korea, argues that clofazimine might be a better choice than rifampin for treating MAC. He also mentions recent studies that showed that a two drug regimen of a macrolide plus ethambutol was as effective as the Big 3 regimen of a macrolide plus ethambutol and rifampin.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12277505/
In the United States clofazimine is considered an investigational drug, so obtaining a prescription can take a bit of work. Another option might be to join a Phase 3 clinical trial of inhaled clofazimine, which is currently recruiting at multiple locations. Whatever your treatment plan consists of, I wish you the best of luck and smooth sailing.
https://www.icon-1study.com

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kathyjjb | @kathyjjb | Oct 11, 2025

In reply to @sofarsurvivor139 "I have not started my treatment yet for MAC Abscessus I am interested in information." + (show)

@sofarsurvivor139 Do You have cavities? I was diagnosed with M. Abscessus November 2024. In May of 2025, my local ID doctor put me on Nuzyra, Linezolid, and Arikayce. I had my NJH 2-week appointment set for about 2.5 weeks after I started the antibiotics. The first week, NJH took me off the Arikayce since I could not talk at all, and they suggested I go to inhaled IV Amakacin. Also, my Linezolid dose was cut in half after they took a series of blood tests to see how my body metabolized the Linezolid. I did have a months supply of free Nuzyra (samples given to me by my local ID doctor) but NJH suggested I switch to Clofazamine. There was a study that I was going to join. Fortunately, after all my testing, my treatment was stopped. My M.Abscessus count was very low (NJH lab is the best) and they wanted to wait and watch. They also had me switch nebulizers to the Aerobika. My last 4 cultures have been negative but in August a new nodule showed up, so now I am scheduled for a CXR next month to see if it's still there. I highly recommend going to NJH, if you haven't already. I hope you are nebulizing with 7% saline 2/day.