cris.boxmetadata.label.title
Susceptibilities of MDR Mycobacterium tuberculosis isolates to unconventional drugs compared with their reported pharmacokinetic/pharmacodynamic parameters
cris.boxmetadata.label.dateissued
01 browse.startsWith.months.june 2017
cris.boxmetadata.label.accesslevel
open access
cris.boxmetadata.label.resourcetype
journal article
cris.boxmetadata.label.authors
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.
cris.boxmetadata.label.publisher
Oxford University Press
cris.boxmetadata.label.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.
cris.boxmetadata.label.citationstartpage
1678
cris.boxmetadata.label.citationendpage
1687
cris.boxmetadata.label.volume
72
cris.boxmetadata.label.issue
6
cris.boxmetadata.label.language
English
cris.boxmetadata.label.ocdeknowledgeArea
Farmacología, Farmacia
Enfermedades infecciosas
cris.boxmetadata.label.doi
cris.boxmetadata.label.scopusidentifier
2-s2.0-85027369488
cris.boxmetadata.label.pubmedidentifier
cris.boxmetadata.label.source
Journal of Antimicrobial Chemotherapy
cris.boxmetadata.label.containerissn
03057453
peru-layout.shadow-copies
Directorio de Producción Científica
Scopus