title: Activities of moxifloxacin in combination with macrolides against clinical isolates of Mycobacterium abscessus and Mycobacterium massiliense.
abstract: Infections caused by Mycobacterium abscessus and Mycobacterium massiliense are on the rise among humans. Although macrolides, including clarithromycin (CLR) and azithromycin (AZM), are key antibiotics for the treatment of M. abscessus and M. massiliense infections, treatment regimens for these infections are still largely undefined. In this study, we evaluated the in vitro, ex vivo, and in vivo activities of moxifloxacin (MXF) in combination with macrolides against clinically isolated M. abscessus and M. massiliense strains. Overall, CLR, AZM, and MXF alone showed activity against both species in vitro, ex vivo, and in vivo. When MXF was combined with a macrolide against M. abscessus isolates, antagonism was observed in 65.4% (17/26) of the strains with CLR and 46.2% (12/26) of the strains with AZM in vitro as well as in 66.7% (10/15) of the strains with CLR and 40.0% (6/15) of the strains with AZM in macrophages as determined by the fractional inhibitory concentration index. In contrast, either indifferent or synergistic effects of the MXF-macrolide combinations were observed against only M. massiliense strains. Moreover, a murine infection model showed similar results. Antagonism between the MXF and macrolide combinations was observed in five out of seven M. abscessus strains, while indifferent and synergistic effects for these combinations were observed for three of the six M. massiliense strains tested, respectively. In conclusion, the activity of MXF in combination with a macrolide differed for M. abscessus and M. massiliense infections and the addition of MXF to macrolide therapy had no benefit for the treatment of M. abscessus infections.
authors.affiliation: Department of Microbiology and Research Institute for Medical Sciences, College of Medicine, Chungnam National University, Daejeon, South Korea.
authors.forename: Go-Eun
authors.initials: GE
authors.lastname: Choi
authors.forename: Ki-Nam
authors.initials: KN
authors.lastname: Min
authors.forename: Choul-Jae
authors.initials: CJ
authors.lastname: Won
authors.forename: Kyeongman
authors.initials: K
authors.lastname: Jeon
authors.forename: Sung Jae
authors.initials: SJ
authors.lastname: Shin
authors.forename: Won-Jung
authors.initials: WJ
authors.lastname: Koh
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use; D001372:Aza Compounds / Q000494:pharmacology* / Q000627:therapeutic use; D002478:Cells, Cultured; D005260:Female; D024841:Fluoroquinolones; D018942:Macrolides / Q000494:pharmacology* / Q000627:therapeutic use; D051379:Mice; D008810:Mice, Inbred C57BL; D008826:Microbial Sensitivity Tests; D000077266:Moxifloxacin; D009161:Mycobacterium / Q000187:drug effects* / Q000235:genetics; D009164:Mycobacterium Infections / Q000188:drug therapy; D011804:Quinolines / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D018942:Macrolides; D011804:Quinolines; D000077266:Moxifloxacin