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Antimicrobial Agents and Chemotherapy, November 2001, p. 3109-3112, Vol. 45, No. 11
Laboratoire de Bactériologie,
Faculté de Médecine Pitié-Salpêtrière,
Paris, France
Received 26 March 2001/Returned for modification 4 June
2001/Accepted 8 August 2001
Mice infected in the left hind footpad with 5 log10
acid-fast bacilli of Mycobacterium ulcerans were divided
into an untreated control group and 17 treatment groups that received
one of the following regimens for 4 weeks (all doses in milligrams per
kilogram): 100 mg of azithromycin (AZM), 100 mg of clarithromycin
(CLR), or 50 mg of AZM for a duration of 5 days a week (daily), three times a week, or once weekly. In addition, the following regimens were
administered daily: 100 mg of telithromycin (TLM), sparfloxacin (SPX),
or moxifloxacin (MOX); 200 mg of levofloxacin (LVX); 100 mg of
streptomycin (STR) or amikacin (AMK); 10 mg of rifampin (RIF); and the
combination of 10 mg of RIF and 100 mg of AMK (RIF+AMK). After
completion of treatment, mice were observed for 30 weeks. The
effectiveness of treatment regimens was assessed in terms of the delay
in median time to footpad swelling in treated mice compared with that
in the untreated controls. Clear-cut bactericidal activity, i.e., an
observed delay in footpad swelling that exceeded the period of
treatment, was observed in the STR-, AMK-, and RIF+AMK-treated mice.
However, all mice treated with either AMK or STR alone had swollen
footpads before the end of the 30-week observation period, suggesting
regrowth of M. ulcerans. In contrast, 50% of the
mice treated with the RIF+AMK combination exhibited no lesion even after 30 weeks, suggesting cure. The remaining regimens could be
assigned to one of three groups: (i) no activity (50 mg of AZM, 100 mg
of AZM thrice weekly, TLM, and LVX); (ii) bacteriostatic activity, i.e., a delay in footpad swelling shorter than
the 4-week treatment duration (100 mg of AZM daily or once weekly, CLR
thrice or once weekly, and MOX); or (iii) weak bactericidal activity (CLR daily and SPX). The RIF+AMK combination and possibly RIF+STR warrant further study for the treatment of M. ulcerans
infection in humans.
0066-4804/01/$04.00+0 DOI: 10.1128/AAC.45.11.3109-3112.2001
Copyright © 2001, American Society for Microbiology. All rights reserved.
Activities of New Macrolides and Fluoroquinolones
against Mycobacterium ulcerans Infection in
Mice
*
Corresponding author. Mailing address: Laboratoire de
Bactériologie, Faculté de Médecine
Pitié-Salpêtrière, 91 Boulevard de l'Hôpital,
75634 Paris Cedex 13, France. Phone: (33) 1 40 77 97 46. Fax: (33) 1 45 82 75 77. E-mail: jacques_grosset{at}yahoo.com.
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