Sterilizing activities of novel combinations lacking first- and second-line drugs in a murine model of tuberculosis

Kathy Williams, Austin Minkowski, Opokua Amoabeng, Charles A. Peloquin, Dinesh Taylor, Koen Andries, Robert S. Wallis, Khisimuzi E. Mdluli, Eric Nuermberger

Research output: Contribution to journalArticle

Abstract

Novel oral regimens composed of new drugs with potent activity against Mycobacterium tuberculosis and no cross-resistance with existing agents are needed to shorten and simplify treatment for both drug-susceptible and drug-resistant tuberculosis. As part of a continuing effort to evaluate novel drug combinations for treatment-shortening potential in a murine model, we performed two long-term, relapse-based experiments. In the first experiment, several 3- and 4-drug combinations containing new agents currently in phase 2/3 trials (TMC207 [bedaquiline], PA-824 and PNU-100480 [sutezolid], and/or clofazimine) proved superior to the first-line regimen of rifampin, pyrazinamide, and isoniazid. TMC207 plus PNU-100480 was the most effective drug pair. In the second experiment, in which 3- and 4-drug combinations composed of TMC207 and pyrazinamide plus rifapentine, clofazimine, PNU-100480, or both rifapentine and clofazimine were evaluated, the rank order of drugs improving the sterilizing activity of TMC207 and pyrazinamide was as follows: rifapentine plus clofazimine ≥ clofazimine ≥ rifapentine > PNU-100480. The results revealed potential new building blocks for universally active short-course regimens for drug-resistant tuberculosis. The inclusion of pyrazinamide against susceptible isolates may shorten the duration of treatment further.

Original languageEnglish (US)
Pages (from-to)3114-3120
Number of pages7
JournalAntimicrobial Agents and Chemotherapy
Volume56
Issue number6
DOIs
Publication statusPublished - Jun 2012

    Fingerprint

ASJC Scopus subject areas

  • Pharmacology (medical)
  • Pharmacology
  • Infectious Diseases

Cite this