Mefloquine, moxifloxacin, and ethambutol are a triple-drug alternative to macrolide-containing regimens for treatment of Mycobacterium avium disease.

TitleMefloquine, moxifloxacin, and ethambutol are a triple-drug alternative to macrolide-containing regimens for treatment of Mycobacterium avium disease.
Publication TypeJournal Article
Year of Publication2003
AuthorsBermudez LE, Kolonoski P, Petrofsky M, Wu M, Inderlied CB, Young LS
JournalThe Journal of infectious diseases
Volume187
Issue12
Pagination1977-80
Date Published2003 Jun 15
ISSN0022-1899
KeywordsAnimals, Anti-Bacterial Agents, Anti-Infective Agents, Antimalarials, Aza Compounds, Clarithromycin, Disease Models, Animal, Drug Resistance, Bacterial, Drug Therapy, Combination, Ethambutol, Fluoroquinolones, Mefloquine, Mice, Mycobacterium avium Complex, Mycobacterium avium-intracellulare Infection, Quinolines
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.

DOI10.1086/375352
Alternate JournalJ. Infect. Dis.