title: Activity of amoxicillin/clavulanate in patients with tuberculosis.
abstract: Some beta-lactam antibiotics are active in vitro against Mycobacterium tuberculosis. There are anecdotal reports of successful treatment of tuberculosis caused by multiple-drug-resistant strains of M. tuberculosis with regimens that included amoxicillin/clavulanate. Reduction of M. tuberculosis in the sputum of patients with pulmonary tuberculosis during administration of amoxicillin/clavulanate was measured by a quantitative culture method to determine the activity in vivo. Patients were randomized to receive isoniazid, ofloxacin, or amoxicillin/clavulanate for 7 days. Isoniazid was the most effective agent, reducing M. tuberculosis after 2 days at a mean rate (+/- standard deviation) of 0.60 +/- 0.30 log10 cfu/mL per day, compared with 0.32 +/- 0.05 and 0.34 +/- 0.03 for ofloxacin and amoxicillin/clavulanate, respectively. The early bactericidal activity of amoxicillin/clavulanate was comparable to that reported for antituberculous agents other than isoniazid. Further studies of beta-lactam antibiotics with in vitro activity against M. tuberculosis are warranted to define their role in treatment of tuberculosis.
authors.affiliation: Medical Service, San Francisco General Hospital, California, USA.
authors.forename: H F
authors.initials: HF
authors.lastname: Chambers
authors.forename: T
authors.initials: T
authors.lastname: Kocagöz
authors.forename: T
authors.initials: T
authors.lastname: Sipit
authors.forename: J
authors.initials: J
authors.lastname: Turner
authors.forename: P C
authors.initials: PC
authors.lastname: Hopewell
mesh_terms: D000293:Adolescent; D000328:Adult; D000658:Amoxicillin / Q000627:therapeutic use*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D000995:Antitubercular Agents / Q000627:therapeutic use*; D019818:Clavulanic Acid / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D006801:Humans; D009169:Mycobacterium tuberculosis / Q000187:drug effects; D013183:Sputum / Q000382:microbiology; D014397:Tuberculosis, Pulmonary / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000995:Antitubercular Agents; D019818:Clavulanic Acid; D000658:Amoxicillin