Evaluation of Treatment for Mycobacterium Avium Complex (MAC) Infection in HIV-Infected Patients

Inclusion Criteria Concurrent Medication: Allowed: * Any antiretroviral therapy that is approved or is available through an FDA-sanctioned treatment IND or treatment protocol. * Primary or secondary PCP prophylaxis with TMP/SMX, dapsone, or aerosolized pentamidine, as well as approved therapies for other AIDS-related opportunistic infections not otherwise excluded. * Erythromycin, interferon-alpha, and supportive care for any therapy-related toxicities as necessary. Patients must have: * HIV infection. * Confirmed MAC bacteremia. * Consent of parent or guardian if less than 18 years of age. Exclusion Criteria Concurrent Medication: Excluded: * MAC inhibitors, including aminoglycosides, quinolones, clofazimine, azithromycin (except when administered as a substitute drug), and rifamycins, during the first 24 weeks of the study. * Immunomodulators (including colony-stimulating cytokines such as GM-CSF and G-CSF) other than those that are specifically allowed. * Steroids in excess of physiologic replacement doses. * Cytotoxic chemotherapy. Patients with the following prior conditions are excluded: * History of treatment-limiting intolerance or hypersensitivity to the study drugs or other macrolides. * Changes on chest radiograph within 7 days prior to study entry, that are consistent with acute Pneumocystis carinii pneumonia, pulmonary tuberculosis, or other acute respiratory infection. Prior Medication: Excluded: * Clarithromycin, azithromycin, or ethambutol for more than 10 consecutive days within the 8 weeks prior to study entry OR between the time an initial AFB positive blood sample was collected and study entry. * Cytokines (other than erythropoietin and interferon-alpha) within 8 weeks prior to study entry. * Steroids within 8 weeks prior to study entry. * Cytotoxic chemotherapy within 8 weeks prior to study entry. * Acute therapy for an AIDS-related opportunistic infection or malignancy, or other acute medical illness or infection within 4 weeks prior to study entry. * Rifabutin monotherapy if initiated for MAC prophylaxis between the time an initial AFB positive blood sample was collected and study entry. * Aminoglycosides, quinolones, clofazimine, or rifamycins IF ADMINISTERED IN ANY COMBINATION within 7 days prior to study entry OR between the time an initial AFB positive blood sample was collected and study entry.