Title
Susceptibilities of MDR Mycobacterium tuberculosis isolates to unconventional drugs compared with their reported pharmacokinetic/pharmacodynamic parameters
Date Issued
01 June 2017
Access level
open access
Resource Type
journal article
Author(s)
Cavanaugh J.S.
Jou R.
Wu M.H.
Dalton T.
Kurbatova E.
Ershova J.
Cegielski J.P.
Lancaster J.
Odendaal R.
Diem L.
Tan K.
Walker A.T.
Sigman E.
Metchock B.
Perez M.T.C.
Gler M.T.
Norvaisha I.
Skenders G.
Sture I.
Riekstina V.
Cirule A.
Cho S.N.
Eum S.
Lee J.
Cai Y.
Shamputa I.C.
Kuznetsova T.
Akksilp R.
Sitti W.
Inyapong J.
Kiryanova E.V.
Degtyareva I.
Nemtsova E.S.
Levina K.
Danilovits M.
Kummik T.
Lei Y.C.
Huang W.L.
Erokhin V.V.
Chernousova L.N.
Andreevskaya S.N.
Larionova E.E.
Smirnova T.G.
Publisher(s)
Oxford University Press
Abstract
Background: The second-line drugs recommended to treat drug-resistant TB are toxic, expensive and difficult to procure. Given increasing resistance, the need for additional anti-TB drugs has become more urgent. But new drugs take time to develop and are expensive. Some commercially available drugs have reported antimycobacterial activity but are not routinely used because supporting laboratory and clinical evidence is sparse. Methods: We analysed 217 MDR M. tuberculosis isolates including 153 initial isolates from unique patients and 64 isolates from follow-up specimens during the course of treatment. The resazurinmicrodilution assaywas performed to determine MICs of trimethoprim/sulfamethoxazole, mefloquine, thioridazine, clofazimine, amoxicillin/clavulanate, meropenem/clavulanate, nitazoxanide, linezolid and oxyphenbutazone. Isoniazid was used for validation. We calculated theMIC50 andMIC90 as theMICs atwhich growth of 50% and 90% of isolates was inhibited, respectively. Results: TheMIC50s, in mg/L, for initial isolateswere as follows: trimethoprim/sulfamethoxazole, 0.2/4;mefloquine, 8; thioridazine, 4; clofazimine, 0.25; amoxicillin/clavulanate, 16/8; meropenem/clavulanate, 1/2.5; nitazoxanide, 16; linezolid, 0.25; and oxyphenbutazone, 40. The MIC90s, in mg/L, for initial isolateswere as follows: trimethoprim/sulfamethoxazole, 0>4/8; mefloquine, 8; thioridazine, 8; clofazimine, 0.5; amoxicillin/clavulanate, 32/16; meropenem/clavulanate, 8/2.5; nitazoxanide, 16; linezolid, 0.25; and oxyphenbutazone, 60. By comparison, the MIC90 of isoniazid was > 4 mg/L, as expected. There was no evidence that previous treatment affected susceptibility to any drug. Conclusions: Most drugs demonstrated efficacy against M. tuberculosis. When these MICs are compared with the published pharmacokinetic/pharmacodynamic profiles of the respective drugs in humans, trimethoprim/sulfamethoxazole, meropenem/clavulanate, linezolid, clofazimine and nitazoxanide appear promising and warrant further clinical investigation.
Start page
1678
End page
1687
Volume
72
Issue
6
Language
English
OCDE Knowledge area
Farmacología, Farmacia Enfermedades infecciosas
Scopus EID
2-s2.0-85027369488
PubMed ID
Source
Journal of Antimicrobial Chemotherapy
ISSN of the container
03057453
Sources of information: Directorio de Producción Científica Scopus