Walker L L, Van Landingham R M, Shinnick T M
Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
Int J Lepr Other Mycobact Dis. 1993 Mar;61(1):59-65.
The anti-Mycobacterium leprae activity of clarithromycin when administered alone and in combination with rifampin and dapsone in the diet was determined using the kinetic method of drug evaluation in mice. Clarithromycin when administered at a concentration of 0.1% (w/w) in the diet completely prevented growth of 2 pan-susceptible, 3 dapsone-resistant, 2 rifampin-resistant, and 2 rifampin and dapsone double resistant strains of M. leprae. A 0.03% (w/w) concentration also completely prevented growth of M. leprae in all mice infected with 2 of 7 strains tested, but in only some of the mice infected with the remaining 5 strains. No antagonistic drug interactions were observed between clarithromycin and dapsone or rifampin. The addition of clarithromycin to the currently recommended multidrug regimen should improve the rate of killing of M. leprae and help to prevent the growth of dapsone-resistant and rifampin-resistant strains.
采用小鼠药物评价动力学方法，测定了单独使用克拉霉素以及将其与利福平、氨苯砜联合添加到饮食中时的抗麻风分枝杆菌活性。当在饮食中以0.1%（w/w）的浓度给予克拉霉素时，可完全抑制2株全敏感、3株耐氨苯砜、2株耐利福平以及2株耐利福平和氨苯砜的麻风分枝杆菌菌株的生长。0.03%（w/w）的浓度也能完全抑制所有感染7种测试菌株中2种的小鼠体内麻风分枝杆菌的生长，但仅能抑制部分感染其余5种菌株的小鼠体内麻风分枝杆菌的生长。未观察到克拉霉素与氨苯砜或利福平之间存在拮抗药物相互作用。在目前推荐的多药治疗方案中添加克拉霉素应能提高麻风分枝杆菌的杀灭率，并有助于防止耐氨苯砜和耐利福平菌株的生长。
