Safety and tolerability of clarithromycin in the treatment of multidrug-resistant tuberculosis

[摘要] ExtractMultidrug-resistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) are an emerging global threat. An estimated 3.3% of newly diagnosed TB patients and 20% of previously treated patients worldwide have MDR-TB [1]. Moreover; 9.7% of MDR-TB cases are suffering from XDR-TB. Treatment of TB is becoming more difficult since the resistance pattern of Mycobacterium tuberculosis is expanding and treatment success rate is decreasing; with newly emerging drug-resistant strains [2]. Therefore; evaluation of antimicrobial drugs active against M. tuberculosis is necessary. Clarithromycin (CLR) is a macrolide antibiotic previously listed as a World Health Organization (WHO) group 5 drug; but not included in the new WHO classification because it has only modest bacteriostatic effects against M. tuberculosis [3]. However; the in vitro synergy of CLR in combination with linezolid; ethambutol and spectinomycin; and its immunomodulatory effects; hold promise [4xe2x80x936]. Despite the introduction of newer drugs such as bedaquiline and delamanid; clarithromycin may have added value for the treatment of TB patients in cases of extensive resistance but proven susceptibility to clarithromycin. Unfortunately; real-life data on the use of clarithromycin to guide physicians in the treatment of MDR-TB is scarce.

[学科分类] 呼吸医学