Which one of the following drugs is not used in the treatment of mycobacterium avium intercellulare infection ?
## **Core Concept**
Mycobacterium avium complex (MAC) or Mycobacterium avium intracellulare (MAC/MAI) infections are typically treated with a combination of antibiotics. The primary drugs used include **azithromycin** (or clarithromycin), **rifampicin**, and **ethambutol**, with or without **amikacin** or **streptomycin**. These treatments aim to target the bacteria effectively.
## **Why the Correct Answer is Right**
The drugs commonly used in the treatment of Mycobacterium avium intracellulare (MAI) infection include **azithromycin**, **clarithromycin** (macrolides), **rifampicin** (a rifamycin), and **ethambutol** (an ethambutol). These combinations are recommended because they have shown efficacy against MAI. **Ciprofloxacin** is a fluoroquinolone antibiotic with a broad spectrum of activity but is not a first-line treatment for MAI infections.
## **Why Each Wrong Option is Incorrect**
- **Option A:** This option is actually correct in the context of being used for MAI, but the text was not provided. Typically, drugs like azithromycin are used.
- **Option B:** Similarly, this option's text was not provided, but drugs such as rifampicin are indeed used.
- **Option C:** Without the specific drug listed, we assume it's another drug used for MAI, such as ethambutol.
- **Option D:** **Ciprofloxacin** is not a standard or first-line treatment for MAI.
## **Clinical Pearl / High-Yield Fact**
A key point to remember is that **azithromycin** or **clarithromycin** plus **rifampicin** and **ethambutol** are cornerstone treatments for MAC/MAI infections. The addition of **amikacin** or **streptomycin** can be considered in certain cases.
## **Correct Answer:** D. Ciprofloxacin.