In vitro activity of aminoglycosides, clofazimine, d-cycloserine and dapsone against 83 Mycobacterium avium complex clinical isolates
Abstract
BACKGROUND/PURPOSE
Treatment success rates for Mycobacterium avium complex (MAC) diseases range from 50% to 55% only. To explore effective antimicrobials against either Mycobacterium intracellulare or M. avium, we determined in vitro activities of five aminoglycosides, clofazimine, dapsone and d-cycloserine compared with primary (clarithromycin) and secondary (moxifloxacin and linezolid) antimycobacterial agents.
METHODS
83 non-duplicate clinical MAC isolates were collected from sputum and identified at the species level by PCR and restriction enzyme analysis of the 65 kDa hsp and rpoB genes. Drug susceptibility testing was performed using broth microdilution method. The fractional inhibitory concentration was calculated to determine synergy between isepamicin and clofazimine.
RESULTS
High susceptibility rates of five aminoglycosides (isepamicin, amikacin, kanamycin, streptomycin, capreomycin, 82.7-88%), d-cycloserine (82.7%), clofazimine (97.3%) and clarithromycin (92%) against M. intracellulare, and 2 aminoglycosides (isepamicin, streptomycin, 87.5%), d-cycloserine (100%) and clarithromycin (100%) against M. avium were found. Dapsone had no inhibitory activity and moxifloxacin had little effect against both M. intracellulare and M. avium. Linezolid had modest activity whereas clofazimine had little effect against M. avium. Most MAC isolates with non-susceptibility to isepamicin were also non-susceptible to the other four aminoglycosides. Most streptomycin-susceptible MAC…
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