Abstract
Macrolides are the core of effective drug regimens for the treatment of Mycobacterium avium complex (MAC) disease. Mefloquine (MFQ), moxifloxacin (MXF), and ethambutol (EMB), in combination, were evaluated against both clarithromycin-resistant (CLR-R) and CLR-susceptible (CLR-S) MAC; MFQ (40 mg/kg), MXF (100 mg/kg), or EMB (100 mg/kg/day) was given to mice for 4 weeks. MFQ was bactericidal, whereas MXF and EMB were bacteriostatic against both MAC 101 CLR-S and CLR-R. The combination of MFQ and EMB reduced (P<.05, for comparison with controls), and the combination of MFQ and MXF significantly reduced, the load of CLR-R in both the liver and the spleen. Treatment with all 3 drugs was associated with approximately 1-log reduction of CLR-R after 1 week, 2.1-log reduction of CLR-R after 4 weeks, and 2.17-log reduction in MAC/mL blood. Treatment of MAC 101 CLR-S strain had comparable results.
Publication types
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Animals
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Anti-Bacterial Agents / pharmacology
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Anti-Bacterial Agents / therapeutic use*
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Anti-Infective Agents / pharmacology
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Anti-Infective Agents / therapeutic use*
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Antimalarials / pharmacology
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Antimalarials / therapeutic use*
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Aza Compounds*
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Clarithromycin / pharmacology
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Disease Models, Animal
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Drug Resistance, Bacterial
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Drug Therapy, Combination
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Ethambutol / pharmacology
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Ethambutol / therapeutic use*
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Fluoroquinolones*
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Mefloquine / pharmacology
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Mefloquine / therapeutic use*
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Mice
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Moxifloxacin
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Mycobacterium avium Complex / drug effects
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Mycobacterium avium-intracellulare Infection / drug therapy*
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Mycobacterium avium-intracellulare Infection / microbiology
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Quinolines*
Substances
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Anti-Bacterial Agents
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Anti-Infective Agents
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Antimalarials
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Aza Compounds
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Fluoroquinolones
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Quinolines
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Ethambutol
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Clarithromycin
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Mefloquine
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Moxifloxacin