{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T14:59:07Z","timestamp":1789657147526,"version":"4.0.1"},"reference-count":13,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Microbial Drug Resistance"],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:p>\n                    Patients with cystic fibrosis (CF) are at risk for recurrent pulmonary infections due to increased viscosity of airway secretions, leading to persistent colonization with pathogenic bacteria, including nontuberculous mycobacteria (NTM). Extensive antibiotic use for treatment of infections has led to increasing antimicrobial resistance, which is a significant barrier to the treatment of NTMs. We examined the\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    activity of several antibiotics against a selection of the most drug-resistant clinical isolates of\n                    <jats:italic toggle=\"yes\">Mycobacterium abscessus<\/jats:italic>\n                    ,\n                    <jats:italic toggle=\"yes\">Mycobacterium chelonae<\/jats:italic>\n                    , and\n                    <jats:italic toggle=\"yes\">Mycobacterium avium<\/jats:italic>\n                    complex recovered from CF patients at our institution, as well as paired combinations of antibiotics against a subset of\n                    <jats:italic toggle=\"yes\">M. abscessus<\/jats:italic>\n                    strains, to determine whether they exhibit synergy in inhibiting bacterial growth. Most isolates displayed resistance to at least six of the nine antibiotics tested for which phenotypic interpretation is available, and elevated minimum inhibitory concentrations (MICs) were observed for many of the other drugs. The major exception was clofazimine, which had relatively low MICs for most isolates across all species. When synergy testing was performed by using paired combinations of drugs, clofazamine and clarithromycin exhibited 100% synergy for all combinations tested, as did amikacin, with the exception of one isolate. These results suggest that synergistic antibiotic combinations are capable of overcoming drug resistance\n                    <jats:italic toggle=\"yes\">in vitro<\/jats:italic>\n                    , and laboratories might consider implementation of synergy testing in multidrug-resistant (MDR)-NTM organisms to guide treatment decisions in the setting of extensive antimicrobial resistance.\n                  <\/jats:p>","DOI":"10.1089\/mdr.2017.0286","type":"journal-article","created":{"date-parts":[[2018,1,25]],"date-time":"2018-01-25T11:55:43Z","timestamp":1516881343000},"page":"1191-1197","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":28,"title":["Activities of Dual Combinations of Antibiotics Against Multidrug-Resistant Nontuberculous Mycobacteria Recovered from Patients with Cystic Fibrosis"],"prefix":"10.1177","volume":"24","author":[{"given":"Matthew","family":"Schwartz","sequence":"first","affiliation":[{"name":"The Johns Hopkins School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Fisher","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Story-Roller","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gyanu","family":"Lamichhane","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Parrish","sequence":"additional","affiliation":[{"name":"The Johns Hopkins School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,10,9]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"Foundation C.F. 2014. Cystic Fibrosis Foundation Patient Registry: Annual Data Report to the Center Directors. Cystic Fibrosis Foundation Bethesda MD."},{"key":"e_1_3_3_3_2","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1164\/rccm.200207-678OC","article-title":"Nontuberculous mycobacteria. I: multicenter prevalence study in cystic fibrosis","volume":"167","author":"Olivier K.N.","year":"2003","unstructured":"Olivier K.N., , Weber D.J., , Wallace R.J.Jr., , Faiz A.R., , Lee J.H., , Zhang Y., , Brown-Elliot B.A., , Handler A., , Wilson R.W., , Schechter M.S., , Edwards L.J., , Chakraborti S., , Knowles M.R.; Nontuberculous Mycobacteria in Cystic Fibrosis Study Group. 2003. Nontuberculous mycobacteria. I: multicenter prevalence study in cystic fibrosis. Am. J. Respir. Crit. Care Med., 167:828\u2013834.","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"e_1_3_3_4_2","doi-asserted-by":"crossref","first-page":"662","DOI":"10.1097\/MCP.0b013e328365ab33","article-title":"Nontuberculous mycobacteria: the changing epidemiology and treatment challenges in cystic fibrosis","volume":"19","author":"Leung J.M.","year":"2013","unstructured":"Leung J.M., , and Olivier K.N.. 2013. Nontuberculous mycobacteria: the changing epidemiology and treatment challenges in cystic fibrosis. Curr. Opin. Pulm. Med., 19:662\u2013669.","journal-title":"Curr. Opin. Pulm. Med."},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000104"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcf.2009.12.001"},{"key":"e_1_3_3_7_2","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/S1569-1993(16)00018-7","article-title":"US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis","volume":"15","author":"Flume P.A.","year":"2016","unstructured":"Flume P.A. 2016. US Cystic Fibrosis Foundation and European Cystic Fibrosis Society consensus recommendations for the management of non-tuberculous mycobacteria in individuals with cystic fibrosis. J. Cyst. Fibros., 15:139\u2013140.","journal-title":"J. Cyst. Fibros."},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/152.3.500"},{"key":"e_1_3_3_9_2","doi-asserted-by":"crossref","first-page":"6561","DOI":"10.1128\/AAC.01158-15","article-title":"Carbapenems and rifampin exhibit synergy against Mycobacterium tuberculosis and Mycobacterium abscessus","volume":"59","author":"Kaushik A.","year":"2015","unstructured":"Kaushik A., , Makkar N., , Pandey P., , Parrish N., , Singh U., , and Lamichhane G.. 2015. Carbapenems and rifampin exhibit synergy against Mycobacterium tuberculosis and Mycobacterium abscessus. Antimicrob. Agents Chemother., 59:6561\u20136567.","journal-title":"Antimicrob. Agents Chemother."},{"key":"e_1_3_3_10_2","doi-asserted-by":"crossref","first-page":"473","DOI":"10.2217\/fmb-2016-0234","article-title":"Combinations of avibactam and carbapenems exhibit enhanced potencies against drug-resistant Mycobacterium abscessus","volume":"12","author":"Kaushik A.","year":"2017","unstructured":"Kaushik A., , Gupta C., , Fisher S., , Story-Roller E., , Galanis C., , Parrish N., , and Lamichhane G.. 2017. Combinations of avibactam and carbapenems exhibit enhanced potencies against drug-resistant Mycobacterium abscessus. Future Microbiol., 12:473\u2013480.","journal-title":"Future Microbiol."},{"key":"e_1_3_3_11_2","first-page":"595","article-title":"A molecular vulnerability in Mycobacterium avium: an L,D-transpeptidase orthologue in Mycobacterium avium is constitutively expressed and inhibited by carbapenems","volume":"12","author":"Mattoo R.","year":"2017","unstructured":"Mattoo R., , Lloyd E.P., , Kaushik A., , Kumar P., , Brunelle J.L., , Townsend C., , and Lamichhane G.. 2017. A molecular vulnerability in Mycobacterium avium: an L,D-transpeptidase orthologue in Mycobacterium avium is constitutively expressed and inhibited by carbapenems. Future Microbiol., 12:595\u2013607.","journal-title":"Future Microbiol."},{"key":"e_1_3_3_12_2","volume-title":"CLSI","author":"Woods G.L.","year":"2011","unstructured":"Woods G.L., , Brown-Elliot B.A., , Conville P.S., , Desmond E.P., , Hall G.S., , Lin G., , Pfyffer G.E., , Ridderhof J.C., , Siddiqi S.H., , Wallace R.J.Jr., et al. 2011. Susceptibility testing of the Mycobacteria, Nocardiae, and other aerobic Actinomycetes; approved standard, M24-A2, 2nd ed. In: CLSI, (ed.). Clinical and Laboratory Standards Institute, Wayne, PA.","edition":"2"},{"key":"e_1_3_3_13_2","doi-asserted-by":"crossref","first-page":"400","DOI":"10.1016\/j.ijantimicag.2009.12.008","article-title":"High efficacy of clofazimine and its synergistic effect with amikacin against rapidly growing mycobacteria","volume":"35","author":"Shen G.H.","year":"2010","unstructured":"Shen G.H., , Wu B.D., , Hu S.T., , Lin C.F., , Wu K.M., , and Chen J.H.. 2010. High efficacy of clofazimine and its synergistic effect with amikacin against rapidly growing mycobacteria. Int. J. Antimicrob. Agents, 35:400\u2013404.","journal-title":"Int. J. Antimicrob. Agents"},{"key":"e_1_3_3_14_2","doi-asserted-by":"crossref","first-page":"6324","DOI":"10.1128\/AAC.01505-12","article-title":"In vitro synergy between clofazimine and amikacin in treatment of nontuberculous mycobacterial disease","volume":"56","author":"van Ingen J.","year":"2012","unstructured":"van Ingen J., , Totten S.E., , Helstrom N.K., , Heifets L.B., , Boeree M.J., , and Daley C.L.. 2012. In vitro synergy between clofazimine and amikacin in treatment of nontuberculous mycobacterial disease. Antimicrob. Agents Chemother., 56:6324\u20136327.","journal-title":"Antimicrob. Agents Chemother."}],"container-title":["Microbial Drug Resistance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/mdr.2017.0286","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2017.0286","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/mdr.2017.0286","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T20:32:27Z","timestamp":1777667547000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/full\/10.1089\/mdr.2017.0286"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10]]},"references-count":13,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2018,10]]}},"alternative-id":["10.1089\/mdr.2017.0286"],"URL":"https:\/\/doi.org\/10.1089\/mdr.2017.0286","relation":{},"ISSN":["1076-6294","1931-8448"],"issn-type":[{"value":"1076-6294","type":"print"},{"value":"1931-8448","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10]]}}}