Efficacies of three drug regimens containing omadacycline to treat Mycobacteroides abscessus disease - 26/03/24
Abstract |
Mycobacteroides abscessus (Mab, also known as Mycobacterium abscessus) causes opportunistic pulmonary and soft tissue infections that are difficult to cure with existing treatments. Omadacycline, a new tetracycline antibiotic, exhibits potent in vitro and in vivo activity against Mab. As regimens containing multiple antibiotics are required to produce a durable cure for Mab disease, we assessed efficacies of three three-drug combinations in a pre-clinical mouse model of pulmonary Mab disease to identify companion drugs with which omadacycline exhibits the highest efficacy. Additionally, we assessed the susceptibility of Mab recovered from mouse lungs after four weeks of exposure to the three triple-drug regimens. Among the three-drug regimens, omadacycline + imipenem + amikacin produced the largest reduction in Mab burden, whereas omadacycline + imipenem + linezolid exhibited the most effective early bactericidal activity. Omadacycline + linezolid + clofazimine, a regimen that can be administered orally, lacked early bactericidal activity but produced a gradual reduction in the lung Mab burden over time. The robust efficacy exhibited by these three regimens in the mouse model supports their further evaluation in patients with Mab lung disease. As we were unable to isolate drug-resistant Mab mutants at the completion of four weeks of treatment, these triple-drug combinations show promise of producing durable cure and minimizing selection of resistant mutants.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Current treatment recommendations for M. abscessus (Mab) disease are sub-optimal. |
• | Historically, successful treatments of mycobacterial diseases have required combinations of antibiotics. |
• | Omadacycline, a new tetracycline, exhibits potent in vitro and in vivo activity against Mab. |
• | The regimen comprising of omadacycline + imipenem + amikacin exhibited robust efficacy against Mab. |
• | Omadacycline + linezolid + clofazimine, an all-oral regimen, produced a gradual reduction in Mab burden in the lungs of mice. |
Keywords : M. abscessus, Omadacycline, Amikacin, Clofazimine, Imipenem, Linezolid
Plan
Vol 146
Article 102482- mai 2024 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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