Use of mefloquine in multidrug-resistant Mycobacterium avium complex pulmonary disease in an HIV-negative patient

Ramírez, Juan M.; Mason, Carol M.; Ali, Juzar

doi:10.1016/j.curtheres.2007.12.005

Cited by 4 publications

(2 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Mefloquine is an antimalarial agent which has antimycobacterial activity [203] and shows in vitro and in vivo activity against M. avium [204]. One case report describes its successful use as part of a regimen in refractory MAC disease [183] but its clinical efficacy was unclear in another report [205]. The neuroleptic thioridazine also has antimycobacterial activity, has shown in vitro activity against M. avium and accumulates in high concentrations within macrophages, but is limited by neurological and cardiac toxicity [206] and there are no reports of its clinical use in NTM-PD.…”

Section: Antituberculous Drugsmentioning

confidence: 99%

Non-tuberculous mycobacterial pulmonary disease

et al. 2019

View full text Add to dashboard Cite

Nontuberculous mycobacterial pulmonary disease (NTM-PD) is a challenging infection which is becoming increasingly prevalent, particularly in the elderly, for reasons which are unknown. While underlying lung disease is a well-established risk factor for NTM-PD, it may also occur in apparently healthy individuals. No single common genetic or immunological defect has been identified in this group, and it is likely that multiple pathways contribute towards host susceptibility to NTM-PD which further interact with environmental and microbiological factors leading to the development of disease.The diagnosis of NTM-PD relies on the integration of clinical, radiological and microbiological results. The clinical course of NTM-PD is heterogeneous, with some patients remaining stable without the need for treatment and others developing refractory disease associated with considerable mortality and morbidity. Treatment regimens are based on the identity of the isolated species, drug sensitivity testing (for some agents) and the severity of disease. Multiple antibiotics are typically required for prolonged periods of time and treatment is frequently poorly tolerated. Surgery may be beneficial in selected cases. In some circumstances cure may not be attainable and there is a pressing need for better regimens to treat refractory and drug-resistant NTM-PD.This review summarises current knowledge on the epidemiology, aetiology and diagnosis of NTM-PD and discusses the treatment of two of the most clinically significant species, theM. aviumandM. abscessuscomplexes, with a focus on refractory disease and novel therapies.

show abstract

Section: Antituberculous Drugsmentioning

confidence: 99%

Non-tuberculous mycobacterial pulmonary disease

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Although mefloquine is commonly prescribed as prophylaxis against malaria, due to the short duration of the prophylaxis, its antimycobacterial activity was never appreciated. Clinical use of mefloquine in a small number of patients with disseminated and pulmonary Mycobacterium avium infection has been reported showing success [ 8 ]. In addition, mefloquine can be part of a three drug regimen that does not involve macrolides, for M. avium disease as demonstrated in an experimental model of the infection [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Mefloquine and Its Enantiomers Are Active againstMycobacterium tuberculosisIn Vitro and in Macrophages

Bermudez

Meek

2014

Tuberculosis Research and Treatment

View full text Add to dashboard Cite

Objective. Tuberculosis is a serious problem of public health. The increase on the number of clinical cases of tuberculosis infected with multidrug resistant (MDR) M. tuberculosis calls for the development of novel therapy. Design. We investigated the effect of mefloquine and two enantiomers, (+)erythro-mefloquine and (+)threo-mefloquine against M. tuberculosis strains in the environment resembling the aspects of the granuloma environment and in macrophages. Results. The results suggest that mefloquine (racemic mixture) and (+)erythro-mefloquine have bactericidal activity against M. tuberculosis strains both in acidic, low oxygen tension and in macrophages. The activity, however, was impaired under increased osmolarity. Conclusion. Identification of the target for mefloquine in the pathogen will allow for the development of novel drugs with antituberculosis activity.

show abstract