{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T13:37:38Z","timestamp":1785418658258,"version":"3.56.0"},"reference-count":59,"publisher":"American Society for Microbiology","issue":"2","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"funder":[{"DOI":"10.13039\/501100003710","name":"Korea Health Industry Development Institute","doi-asserted-by":"publisher","award":["RS-2025-02193034"],"award-info":[{"award-number":["RS-2025-02193034"]}],"id":[{"id":"10.13039\/501100003710","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2023-00246091"],"award-info":[{"award-number":["RS-2023-00246091"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["RS-2024-00405542"],"award-info":[{"award-number":["RS-2024-00405542"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Antimicrob Agents Chemother"],"published-print":{"date-parts":[[2026,2,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      The\n                      <jats:italic toggle=\"yes\">Mycobacterium avium<\/jats:italic>\n                      complex (MAC) is the primary cause of pulmonary disease (PD) among nontuberculous mycobacteria, presenting a significant treatment challenge on a global scale. A long-term (\u226512 months) three-drug regimen, typically including a macrolide, such as clarithromycin (CLR) or azithromycin, along with rifampicin and ethambutol, is recommended. However, many patients fail to respond adequately to therapy, and some eventually develop macrolide resistance, making the disease even more difficult to treat. This highlights the urgent need for improved therapeutic strategies. Here, we investigated the efficacy of clofazimine (CFZ) and bedaquiline (BDQ), both repurposed from multidrug-resistant tuberculosis therapy, against macrolide-resistant MAC. In macrophage infection assays, both CFZ and BDQ showed significant intracellular inhibitory activity against macrolide-resistant clinical isolates, with CFZ generally exhibiting stronger effects. In a chronic murine model of MAC-caused progressive PD, substitution of CLR with CFZ and BDQ in the treatment regimen led to marked reductions in bacterial loads in both lung and spleen compared with the standard regimen, achieving up to 0.86 log\u2081\u2080 CFU reduction in lung and 2.17 log\u2081\u2080 CFU in spleen tissues. These findings demonstrate that CFZ and BDQ retain potent activity against macrolide-resistant MAC and highlight their potential as promising components of alternative treatment regimens.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/aac.01511-25","type":"journal-article","created":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T14:05:36Z","timestamp":1766153136000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":2,"title":["Evaluation of clofazimine-bedaquiline combination as a candidate regimen for macrolide-resistant\n                    <i>Mycobacterium avium<\/i>\n                    complex 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