Evaluation of macrolides for possible use against multidrug-resistant <i>Mycobacterium tuberculosis</i>

Paardt, Anne-Fleur van der; Wilffert, Bob; Akkerman, Onno W.; Lange, Wiel C M de; Soolingen, Dick van; Sinha, Bhanu; Werf, Tjip S. van der; Kosterink, Jos G. W.; Alffenaar, Jan‐Willem C.

doi:10.1183/09031936.00147014

Cited by 24 publications

(15 citation statements)

References 82 publications

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“…M. tuberculosis has intrinsic, inducible resistance to clarithromycin (207, 208), and in vivo murine TB models confirm the lack of activity of macrolides (209). Clarithromycin may increase linezolid serum exposure when used in combination (210), prompting some consideration of potential synergy between macrolides and other MDR-TB drugs (211). WHO does not recommend use of macrolides to treat MDR-TB (23).…”

Section: Drugs and Drug Classesmentioning

confidence: 99%

Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline

Nahid¹,

Mase²,

Migliori³

et al. 2019

Am J Respir Crit Care Med

329

342

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jointly sponsored this new practice guideline on the treatment of drug-resistant tuberculosis (DR-TB). The document includes recommendations on the treatment of multidrug-resistant TB (MDR-TB) as well as isoniazid-resistant but rifampin-susceptible TB. Methods: Published systematic reviews, meta-analyses, and a new individual patient data meta-analysis from 12,030 patients, in 50 studies, across 25 countries with confirmed pulmonary rifampinresistant TB were used for this guideline. Meta-analytic approaches included propensity score matching to reduce confounding. Each recommendation was discussed by an expert committee, screened for conflicts of interest, according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology. Results: Twenty-one Population, Intervention, Comparator, and Outcomes questions were addressed, generating 25 GRADE-based recommendations. Certainty in the evidence was judged to be very low, because the data came from observational studies with significant loss to follow-up and imbalance in background regimens between comparator groups. Good practices in the management of MDR-TB are described. On the basis of the evidence review, a clinical strategy tool for building a treatment regimen for MDR-TB is also provided. Conclusions: New recommendations are made for the choice and number of drugs in a regimen, the duration of intensive and continuation phases, and the role of injectable drugs for MDR-TB. On the basis of these recommendations, an effective all-oral regimen for MDR-TB can be assembled. Recommendations are also provided on the role of surgery in treatment of MDR-TB and for treatment of contacts exposed to MDR-TB and treatment of isoniazid-resistant TB.

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Section: Drugs and Drug Classesmentioning

confidence: 99%

Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline

Nahid¹,

Mase²,

Migliori³

et al. 2019

Am J Respir Crit Care Med

329

342

View full text Add to dashboard Cite

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“…Therefore, the antimicrobial agents that require a microbial target in active replication are not able to eradicate these infections. Of note, it is important for the new alternative therapies to be evaluated from the viewpoint of the following two facts: 1) clarithromycin, azithromycin, and roxithromycin are used in the prophylactic form for the M. avium infection, and the emergence of resistance in one antibiotic will be equal to resistance to all macrolides and 2) intracellular growth of organism 110. The use of bacteriophage against M. avium infection is a significant alternative and is useful as an antimycobacterial regimen for treating drug-resistant bacteria 109.…”

Section: Phage Therapy In Mycobacterium Avium Infectionsmentioning

confidence: 99%

<p>Phage therapy as a renewed therapeutic approach to mycobacterial infections: a comprehensive review</p>

Azimi¹,

Mosadegh²,

Nasiri³

et al. 2019

IDR

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Mycobacterial infections are considered to a serious challenge of medicine, and the emergence of MDR and XDR tuberculosis is a serious public health problem. Tuberculosis can cause high morbidity and mortality around the world, particularly in developing countries. The emergence of drug-resistant Mycobacterium infection following limited therapeutic technologies coupled with the serious worldwide tuberculosis epidemic has adversely affected control programs, thus necessitating the study of the role bacteriophages in the treatment of mycobacterial infection. Bacteriophages are viruses that are isolated from several ecological specimens and do not exert adverse effects on patients. Phage therapy can be considered as a significant alternative to antibiotics for treating MDR and XDR mycobacterial infections. The useful ability of bacteriophages to kill Mycobacterium spp has been explored by numerous research studies that have attempted to investigate the phage therapy as a novel therapeutic/diagnosis approach to mycobacterial infections. However, there are restricted data about phage therapy for treating mycobacterial infections. This review presents comprehensive data about phage therapy in the treatment of mycobacterial infection, specifically tuberculosis disease.

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“…Cutaneous MTB infection treatment following the recom mendations of the WHO comprises an intensive phase for 2 months, followed by 4 months of a maintenance phase (21). Quinolones or macrolides are recommended by the WHO for multidrugresistant tuberculosis with good safety but unclear efficacy (22,23). In one patient, the first-line drugs were switched to quinolones and ma crolides after an intolerable adverse reaction, resulting in a satisfying outcome.…”

Section: Treatment and Prognosismentioning

confidence: 99%

Cutaneous Tuberculosis and Nontuberculous Mycobacterial Infections at a National Specialized Hospital in China

Mei¹,

Zhang²,

Shi³

et al. 2019

Acta Derm Venerol

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SIGNIFICANCE Cutaneous tuberculosis or nontuberculous mycobacteria infections are frequently underdiagnosed. Although the high burden of tuberculosis and increasing incidence of nontuberculous mycobacteria infections have been recently reported, cutaneous infection caused by tuberculosis and nontuberculous mycobacteria occur rarely and remain unnecessarily reported in most regions of the world. This group of diseases shares many similarities on their histopathology such as granulomatous reaction pattern and their nonspecific clinical presentations. However, the severity, treatment, and prognosis may vary among species and patients. We focused on cutaneous tuberculosis and nontuberculous mycobacteria infections, determined their prevalence, species distribution, and clinical characteristics in the same period, and presented a view of these diseases in Southeast China. To identify the microorganism distribution, clinical characteristics, and management of cutaneous Mycobacterium tuberculosis and nontuberculous mycobacterial infectious diseases in the past 10 years, we collected and analyzed the patient records of all cutaneous M. tuberculosis and nontuberculous mycobacterial infection cases diagnosed by culture and/or PCR from 2008 to 2017 in the Hospital of Dermatology, Chinese Academy of Medical Sciences. Among 203 cases, including 89 M. tuberculosis infections and 114 nontuberculous mycobacterial infections, M. tuberculosis was the most common species in all patients, and M. marinum predominated among the nontuberculous mycobacterial, followed by M. abscessus. Cases of cutaneous mycobacterial infection, especially nontuberculous mycobacterial infection increased in the past 10 years, and infection with rapidly growing mycobacteria significantly increased in the last 5 years in this national hospital in Southeast China. Injuries were common causative factors. Approximately 91.3% of patients responded well to longstanding antibiotic therapy.

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Evaluation of macrolides for possible use against multidrug-resistant Mycobacterium tuberculosis

Cited by 24 publications

References 82 publications

Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline

Treatment of Drug-Resistant Tuberculosis. An Official ATS/CDC/ERS/IDSA Clinical Practice Guideline

<p>Phage therapy as a renewed therapeutic approach to mycobacterial infections: a comprehensive review</p>

Cutaneous Tuberculosis and Nontuberculous Mycobacterial Infections at a National Specialized Hospital in China

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