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Triple oral beta-lactam containing therapy for Buruli ulcer treatment shortening

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The potential use of clinically approved beta-lactams for Buruli ulcer (BU) treatment was investigated with representative classes analyzed in vitro for activity against Mycobacterium ulcerans. Beta-lactams tested were effective alone and displayed a strong synergistic profile in combination with antibiotics currently used to treat BU, i.e. rifampicin and clarithromycin; this activity was further potentiated in the presence of the beta-lactamase inhibitor clavulanate. In addition, quadruple combinations of rifampicin, clarithromycin, clavulanate and beta-lactams resulted in multiplicative reductions in their minimal inhibitory concentration (MIC) values. The MIC of amoxicillin against a panel of clinical isolates decreased more than 200-fold within this quadruple combination. Amoxicillin/clavulanate formulations are readily available with clinical pedigree, low toxicity, and orally and pediatric available; thus, supporting its potential inclusion as a new anti-BU drug in current combination therapies.
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Arenaz-Callao M. P., González del Río R., Lucía Quintana A., Thompson C. J., Mendoza-Losana A, Ramón-García S. (2019) Triple oral beta-lactam containing therapy for Buruli ulcer treatment shortening. PLoS Neglected Tropical Diseases 13(1): e0007126.