Abstract
This study was done to evaluate in vitro susceptibility of Mycobacterium tuberculosis of clarithromycin. In this prospective study, 90 M. tuberculosis strains (40 resistant strains and 50 susceptible strains) referred to the Tabriz laboratory of TB research Center were selected and cultured in L-J medium and with 3 doses of clarithromycin. 40 strains were resistant and 50 strains were sensitive to first line drugs. 60% of strains were resistant to clarithromycin with 20 µg/ml. Significant difference was not found if resistant rate of M. tuberculosis strains to clarithromycin with 20 and 40 µg/ml and all studied strain was sensitive to clarithromycin with 80 µg/ml. 33 strains of resistant strains and 48 strains of sensitive strains to first anti tuberculosis line drug was sensitive to clarithromycin with 40 µg/ml. Based on the results of this study and other studies, the need for extensive laboratory study and using liquid culture (including Midelbary) and advanced techniques such as BACTEC and even more animal models are necessary. The long-term clinical study using clarithromycin in combination with anti-TB therapy, especially in the case of MDR-TB strains is necessary for the low side effect as clarithromycin in the treatment of tuberculosis, in the form of suitable compounds which can be used as second drug. Key words: Mycobacterium tuberculosis, drug resistant, clarithromycin, strains.
Highlights
Re-incidence of infection and disease caused by Mycobacterium tuberculosis and the increasing prevalence of multi-drug resistance among strains of M. tuberculosis evokes the idea that new drugs are still needed (Brennan and Nikaido, 1995)
90 M. tuberculosis strains (40 resistant strains and 50 susceptible strains) referred to the Tabriz laboratory of TB research Center were selected and cultured in L-J medium and with 3 doses of clarithromycin. 40 strains were resistant and 50 strains were sensitive to first line drugs. 60% of strains were resistant to clarithromycin with 20 μg/ml
Significant difference was not found if resistant rate of M. tuberculosis strains to clarithromycin with 20 and 40 μg/ml and all studied strain was sensitive to clarithromycin with 80 μg/ml. 33 strains of resistant strains and 48 strains of sensitive strains to first anti tuberculosis line drug was sensitive to clarithromycin with 40 μg/ml
Summary
Re-incidence of infection and disease caused by Mycobacterium tuberculosis and the increasing prevalence of multi-drug resistance among strains of M. tuberculosis evokes the idea that new drugs are still needed (Brennan and Nikaido, 1995). Clinical experience with macrolides antibiotics for M. tuberculosis is insufficient, the necessity of applying combinations of several drugs in the regimen therapy doubles the need for prior assessments of individual impact of Clarithromycin.Whether clarithromyciniseffective on patients or not was examined by measuring its effect on the improvement of colony forming units (CFU) of M. tuberculosis from sputum of patients with smear-positive pulmonary Tuberculosis (TB) (Mitnick et al, 2008). Increasing incidence of resistant tuberculosis and increasing resistance to anti-mycobacterial drugs, especially in patients infected with human immunodeficiency virus (HIV), points out the immediate need for new compounds to overcome the resistance. Systematic study of macrolides and matching it with data on the susceptibility of M. tuberculosis to antibiotics in this group could be noteworthy in the study on effective compounds (Bosne-David et al, 2000)
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