Muñoz-Muñoz Lara, Aínsa José A, Ramón-García Santiago
Department of Microbiology, Pediatrics, Radiology and Public Health, Faculty of Medicine, University of Zaragoza, 50009 Zaragoza, Spain.
CIBER Respiratory Diseases (CIBERES), Health Institute Carlos III, 28029 Madrid, Spain.
Antibiotics (Basel). 2023 Feb 5;12(2):335. doi: 10.3390/antibiotics12020335.
() causes tuberculosis-like lung infection in both immunocompetent and immunocompromised patients. Current standard therapy against infection is lengthy and difficult to adhere to. Although β-lactams are the most important class of antibiotics, representing 65% of the global antibiotic market, they have been traditionally dismissed for the treatment of mycobacterial infections, as they were considered inactive against mycobacteria. A renewed interest in β-lactams as antimycobacterial agents has shown their activity against several mycobacterial species, including , or ; however, information against is lacking. In this study, we determined the in vitro activity of several β-lactams against . A selection of 32 agents including all β-lactam chemical classes (penicillins, cephalosporins, carbapenems and monobactams) with three β-lactamase inhibitors (clavulanate, tazobactam and avibactam) were evaluated against 22 strains by MIC assays. Penicillins plus clavulanate and first- and third-generation cephalosporins were the most active β-lactams against . Combinatorial time-kill assays revealed favorable interactions of amoxicillin-clavulanate and cefadroxil with first-line treatment. Amoxicillin-clavulanate and cefadroxil are oral medications that are readily available, and well tolerated with an excellent safety and pharmacokinetic profile that could constitute a promising alternative option for therapy.
（）在免疫功能正常和免疫功能低下的患者中都会引起类似肺结核的肺部感染。目前针对该感染的标准治疗疗程长且难以坚持。尽管β-内酰胺类是最重要的抗生素类别，占全球抗生素市场的65%，但传统上它们被排除在治疗分枝杆菌感染之外，因为它们被认为对分枝杆菌无活性。对β-内酰胺类作为抗分枝杆菌药物的重新关注表明它们对几种分枝杆菌具有活性，包括、或；然而，针对的信息尚缺。在本研究中，我们测定了几种β-内酰胺类对的体外活性。通过MIC测定法，对包括所有β-内酰胺化学类别（青霉素类、头孢菌素类、碳青霉烯类和单环β-内酰胺类）以及三种β-内酰胺酶抑制剂（克拉维酸、他唑巴坦和阿维巴坦）在内的32种药物进行了针对22株菌株的评估。青霉素加克拉维酸以及第一代和第三代头孢菌素是对最具活性的β-内酰胺类。联合时间杀菌试验显示阿莫西林-克拉维酸和头孢羟氨苄与一线治疗具有良好的相互作用。阿莫西林-克拉维酸和头孢羟氨苄是口服药物，容易获得，耐受性良好，具有出色的安全性和药代动力学特征，可能构成治疗的一种有前景的替代选择。
