Multidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are an emerging global threat. An estimated 3.3% of newly diagnosed TB patients and 20% of previously treated patients worldwide have MDR-TB [1]. Moreover, 9.7% of MDR-TB cases are suffering from XDR-TB. Treatment of TB is becoming more difficult since the resistance pattern of Mycobacterium tuberculosis is expanding and treatment success rate is decreasing, with newly emerging drug-resistant strains [2]. Therefore, evaluation of antimicrobial drugs active against M. tuberculosis is necessary. Clarithromycin (CLR) is a macrolide antibiotic previously listed as a World Health Organization (WHO) group 5 drug, but not included in the new WHO classification because it has only modest bacteriostatic effects against M. tuberculosis [3]. However, the in vitro synergy of CLR in combination with linezolid, ethambutol and spectinomycin, and its immunomodulatory effects, hold promise [4-6]. Despite the introduction of newer drugs such as bedaquiline and delamanid, clarithromycin may have added value for the treatment of TB patients in cases of extensive resistance but proven susceptibility to clarithromycin. Unfortunately, real-life data on the use of clarithromycin to guide physicians in the treatment of MDR-TB is scarce. CLR is generally a well-tolerated and safe antimicrobial agent. The most frequently reported adverse reactions were nausea, diarrhoea and abdominal pain. Headache was reported frequently [7], and to a lesser extent hepatotoxicity was observed [8]. For MDR-TB treatment, CLR is used for longer treatment periods than initially intended for its labelled indication. In addition, CLR is used in combination with at least three to five other antimicrobial drugs in an MDR-TB treatment regimen. This may potentially result in drugdrug interactions [9] or aggravation of adverse drug reactions. Long-term safety and tolerability have been assessed in HIV patients with nontuberculous mycobacterial infections, but not in MDR-TB patients [10]. Therefore, we evaluated the safety and tolerability of CLR in patients treated for MDR-TB.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.