The newer macrolides are the mainstay of therapy for MAC pulmonary and disseminated disease (Table 4). Intermittent streptomycin for the first 2-3 months of therapy for the first 8 weeks has also been used. For disseminated disease in AIDS, treatment regimens should include clarithromycin or azithromycin and ethambutol and a third agent rifabutin can be used, but drug interactions exist between rifabutin and protease inhibitors. Prophylaxis for MAC, with either azithromycin (1200 mg once weekly) or clarithromycin (500 mg twice daily, BD), is now recommended for all AIDS patients with CD4 cell counts <50 cells/mm3. Rifabutin (300 mg/day) or a combination of azithromycin (1200 mg once weekly) plus rifabutin (300 mg/day) has been proven to be effective.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.