2014
DOI: 10.1093/jac/dku007
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Erm(41)-dependent inducible resistance to azithromycin and clarithromycin in clinical isolates of Mycobacterium abscessus

Abstract: Our findings do not support the suggestion of a preferential use of azithromycin over clarithromycin in order to limit inducible macrolide resistance. Both compounds provoked a comparable resistance phenotype in M. abscessus. Caution is needed when using either azithromycin or clarithromycin for treatment of M. abscessus infections.

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Cited by 88 publications
(100 citation statements)
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References 19 publications
(35 reference statements)
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“…massiliense were susceptible to clarithromycin and harbored an erm (41) (41) sequevars with regard to a T/C polymorphism at nucleotide 28: erm(41) sequevar T28 (Trp 10 codon) associated with inducible resistance and erm(41) sequevar C28 (Arg 10 codon) associated with clarithromycin susceptibility. These results were confirmed using isolates from other countries (19)(20)(21)(22).…”
supporting
confidence: 65%
“…massiliense were susceptible to clarithromycin and harbored an erm (41) (41) sequevars with regard to a T/C polymorphism at nucleotide 28: erm(41) sequevar T28 (Trp 10 codon) associated with inducible resistance and erm(41) sequevar C28 (Arg 10 codon) associated with clarithromycin susceptibility. These results were confirmed using isolates from other countries (19)(20)(21)(22).…”
supporting
confidence: 65%
“…Interestingly, these strains showed increasing MIC levels during prolonged incubation with CLR, but not >4 g/mL at 14 days of incubation; however, the MICs were much lower than those for M. abscessus T28 sequevars. This decrease in susceptibility after prolonged incubation was previously observed and was associated with an increase in mRNA transcripts upon exposure to macrolides [9,21]. [26].…”
Section: Discussionsupporting
confidence: 77%
“…If the results of prolonged DST suggest a susceptibility of M. abscessus species to macrolides, one of the macrolides, preferably azithromycin, should always be part of the drug regimen. Clarithromycin might induce macrolide resistance in the M. abscessus complex more frequently than azithromycin [147], but this finding is not consistent [148]. The choice of companion drugs that will protect the macrolide from resistance is controversial.…”
Section: Managementmentioning
confidence: 99%