{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T22:29:44Z","timestamp":1776810584555,"version":"3.51.2"},"reference-count":13,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T00:00:00Z","timestamp":1421020800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transplant Infectious Dis"],"published-print":{"date-parts":[[2015,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The treatment of <jats:italic>Mycobacterium avium<\/jats:italic> complex (<jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content>) requires prolonged, multidrug therapy, which is often not well tolerated. In solid organ transplant (<jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content>) recipients, drug\u2013drug interactions complicate treatment further. Failure or intolerance requires the use of salvage regimens, and clofazimine is one of the drugs that can be used. No data are available on the safety and tolerability of clofazimine for the treatment of <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> in <jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content> recipients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective review of all <jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content> recipients treated for <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> infection with clofazimine at a large transplant center between 2006 and 2013.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Five <jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content> recipients received clofazimine as salvage therapy. Transplanted organs were lungs in 3 patients, and kidney and liver in 1 patient each. Infection was diagnosed at a median of 22\u00a0months (range 4\u201357) post transplant. Sites of infection were the lungs in 2 patients, and septic arthritis, mesenteric, and disseminated disease in 1 patient each. All patients received standard anti\u2010<jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> therapy for a median of 26\u00a0weeks (range 18\u201345) before starting clofazimine. Indications for use of clofazimine included a lack of response to previous therapy (3 patients), and poor tolerance of other regimens (3 patients). All patients received at least 2 additional drugs besides clofazimine. Median duration of clofazimine\u2010containing regimen was 8\u00a0months (range 2\u201318). Clofazimine was discontinued because of gastrointestinal intolerance in 1 of the 5 patients. The most common adverse event from clofazimine was skin discoloration, in 60% of patients. No hepatotoxicity or hematologic toxicity occurred. Microbiological clearance and resolution of clinical disease was documented in 2 of 5 patients; and 2 of the 5 patients died of other causes while on therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Clofazimine appears safe and may be considered as a salvage therapeutic option in <jats:styled-content style=\"fixed-case\">SOT<\/jats:styled-content> recipients with <jats:styled-content style=\"fixed-case\">MAC<\/jats:styled-content> infection who are intolerant or unresponsive to standard therapy. The small sample size does not allow conclusions regarding efficacy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/tid.12340","type":"journal-article","created":{"date-parts":[[2015,1,12]],"date-time":"2015-01-12T14:06:59Z","timestamp":1421071619000},"page":"111-118","source":"Crossref","is-referenced-by-count":36,"title":["Safety and tolerability of clofazimine as salvage therapy for atypical mycobacterial infection in solid organ transplant recipients"],"prefix":"10.1111","volume":"17","author":[{"given":"P.F.","family":"Cariello","sequence":"first","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.J.","family":"Kwak","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.C.","family":"Abdel\u2010Massih","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"F.P.","family":"Silveira","sequence":"additional","affiliation":[{"name":"Department of Medicine Division of Infectious Diseases University of Pittsburgh Medical Center Pittsburgh Pennsylvania USA"},{"name":"Department of Medicine University of Pittsburgh School of Medicine Pittsburgh Pennsylvania USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,1,12]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200604-571ST"},{"key":"e_1_2_5_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/ajt.12101"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2012.00753.x"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1086\/520141"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s100960050220"},{"key":"e_1_2_5_7_1","volume-title":"Clofazimine Use in Patients with Mycobacterial Infections under Single Patient Investigational New Drug (SPIND)","author":"Vaidya P","year":"2012"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01505-12"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijantimicag.2009.12.008"},{"key":"e_1_2_5_10_1","volume-title":"Lamprene(R) [international package leaflet]","author":"Novartis Pharma AG","year":"2005"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.124.4.1482"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2009.00428.x"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-3062.2010.00549.x"},{"key":"e_1_2_5_14_1","doi-asserted-by":"publisher","DOI":"10.1067\/mpd.2001.111327"}],"container-title":["Transplant Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Ftid.12340","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/tid.12340","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,23]],"date-time":"2023-09-23T18:19:09Z","timestamp":1695493149000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/tid.12340"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2015,1,12]]},"references-count":13,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2015,2]]}},"alternative-id":["10.1111\/tid.12340"],"URL":"https:\/\/doi.org\/10.1111\/tid.12340","archive":["Portico"],"relation":{},"ISSN":["1398-2273","1399-3062"],"issn-type":[{"value":"1398-2273","type":"print"},{"value":"1399-3062","type":"electronic"}],"subject":[],"published":{"date-parts":[[2015,1,12]]}}}