A Comparison of Three Drug Combinations Containing Clarithromycin in the Treatment of Mycobacterium Avium Complex (MAC) Disease in Patients With AIDS

Inclusion Criteria Concurrent Medication: Allowed: * Antiretroviral therapy. * Maintenance or prophylactic therapy for other opportunistic infections (with the exception of specifically excluded drugs). * Carbamazepine or theophylline. * Isoniazid for TB prophylaxis. PER AMENDMENT 10/10/96: * Therapy for acute infectious processes, other than MAC, provided that the patient is stable on the therapy. * Fluconazole therapy for maintenance or suppression of fungal infections, providing the patient has been on a stable dose for at least 4 weeks. PER AMENDMENT 7/02/97: * If a patient elects to receive indinavir, ORTHO/NOVUM 1/35 is an acceptable means of birth control. Patients must have: * HIV infection. * Disseminated MAC disease. * Life expectancy of at least 8 weeks. * Consent of parent or guardian if under 18 years of age. NOTE: * This protocol is approved for prisoner participation. Prior Medication: Allowed: PER AMENDMENT 10/10/96: * Therapy for acute infectious processes, other than MAC, prior to study entry. Exclusion Criteria Co-existing Condition: Patients with the following symptoms or conditions are excluded: * Active mycobacterial infection other than MAC that requires treatment, with the exception of isoniazid used solely for TB prophylaxis. Concurrent Medication: Excluded: * Other antimycobacterial drugs (with the exception of isoniazid for TB prophylaxis). * Other investigational drugs unless approved by protocol chair. PER AMENDMENT 7/2/97: * For patients who elect to receive indinavir or ritonavir: * Terfenadine, astemizole, cisapride, triazolam, or midazolam. * For patients who elect to receive ritonavir: * alprazolam, amiodarone, bepridil, bupropion, cisapride, clorazepate, clozapine, diazepam, dihydroergotamine, ergotamine, estazolam, encainide, flecainide, flurazepam, meperidine, pimozide, piroxicam, propafenone, propoxyphene, quinidine or zolpidem. * For patients who elect to receive indinavir: * oral contraceptives other than ORTHO/NOVUM as a sole form of birth control. * For patients randomized to a rifabutin-containing arm: * oral contraceptives or Norplant as a sole form of birth control. Patients with the following prior condition are excluded: * History of severe hypersensitivity to erythromycin, clarithromycin, azithromycin, ethambutol, rifampin, or rifabutin (including Type 1 hypersensitivity reaction, Stevens-Johnson syndrome, hepatitis, optic neuritis, or exfoliative dermatitis). Prior Medication: Excluded: * Empiric or presumptive antimycobacterial therapy prior to study entry if \> 14 days, within 90 days prior to entry. NOTE: * Patients unwilling to discontinue presumptive therapy or empiric therapy may be enrolled with the permission of the protocol chairs, however, if they are without a MAC positive blood culture at baseline, they will have study medications discontinued (AS PER AMENDMENT 7/2/97). PER AMENDMENT 10/10/96: * Treatment with clarithromycin or ethambutol within 4 days of initiation of study medications. * Treatment with rifabutin or rifampin within 7 days of initiation of study medications.