{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T05:00:50Z","timestamp":1772341250811,"version":"3.50.1"},"reference-count":0,"publisher":"International Union Against Tuberculosis and Lung Disease","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["int j tuberc lung dis"],"published-print":{"date-parts":[[2026,2,27]]},"abstract":"\n <sec><title>OBJECTIVE<\/title>Poor sustained sputum culture conversion with guidelines-based therapy for\n Mycobacterium avium<\/jats:italic>\n complex lung disease highlights the need for new and improved multidrug combinations.<\/sec><sec><title>DESIGN<\/title>We\n tested eight drugs by performing minimum inhibitory concentration (MIC) experiments with the ATCC#700898 strain and 49 clinical isolates, followed by single and multidrug combination studies.<\/sec><sec><title>RESULTS<\/title>MIC\n 90<\/jats:sub>\n of rifabutin, rifampin,\n azithromycin, and ethambutol were 4, 16, 256, and 128 mg\/L, respectively. Among other drugs, MIC\n 90<\/jats:sub>\n (mg\/L) in lowest to highest rank order were for bedaquiline (0.25), tedizolid (16), tebipenem (64), and minocycline (128). As monotherapy, none of the drugs had better MAC kill compared\n to rifampin. While minocycline alone killed 1.76 \u00b1 0.33 log\n 10<\/jats:sub>\n CFU\/mL MAC, replacement of rifabutin in the standard therapy resulted in 6.27 \u00b1 0.28 log\n 10<\/jats:sub>\n CFU\/mL MAC kill, showing minocycline\u2019s synergistic effect with azithromycin and ethambutol. An\n example of a macrolide-rifamycin-ethambutol-free oral regimen, the azithromycin\u2013minocycline\u2013tedizolid combination killed 4.35 \u00b1 0.42 log\n 10<\/jats:sub>\n CFU\/mL MAC. The tebipenem\u2013tedizolid\u2013minocycline combination killed 4.82 \u00b1 0.42 log\n 10<\/jats:sub>\n CFU\/mL;\n however, addition of bedaquiline resulted in a lower kill of 2.71 \u00b1 0.22 log\n 10<\/jats:sub>\n CFU\/mL, suggesting a likely antagonism.<\/sec><sec><title>CONCLUSION<\/title>We tested eight different drugs to identify several rifamycin-, macrolide-, and ethambutol-free\n oral multidrug combinations. The minocycline-based regimens warrant further preclinical and clinical testing.<\/sec>\n <\/jats:p>","DOI":"10.5588\/ijtld.25.0320","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T04:32:39Z","timestamp":1772253159000},"page":"127-133","source":"Crossref","is-referenced-by-count":0,"title":["Rifamycin-, macrolide-, and ethambutol-free combinations to treat\n Mycobacterium avium<\/i>\n complex lung disease"],"prefix":"10.5588","volume":"30","author":[{"given":"G.D.","family":"Boorgula","sequence":"first","affiliation":[{"name":"Divison of Infectious Diseases, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Shrivastava","sequence":"additional","affiliation":[{"name":"Divison of Infectious Diseases, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Singh","sequence":"additional","affiliation":[{"name":"Divison of Infectious Diseases, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.-A.","family":"Galvez","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"P.J.","family":"McShane","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"M.","family":"Devine","sequence":"additional","affiliation":[{"name":"Section of Pulmonary and Critical Care, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"T.","family":"Gumbo","sequence":"additional","affiliation":[{"name":"IMPI Biotech Consortium Inc., Tateguru, Zimbabwe;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Srivastava","sequence":"additional","affiliation":[{"name":"Divison of Infectious Diseases, Department of Medicine, School of Medicine, University of Texas at Tyler, Tyler, TX, USA;, Department of Cellular and Molecular Biology, University of Texas Health Science Centre at Tyler, Tyler, TX, USA."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3554","container-title":["The International Journal of Tuberculosis and Lung Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ingentaconnect.com\/content\/iuatld\/ijtld\/2026\/00000030\/00000003\/art00006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T04:33:35Z","timestamp":1772339615000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ingentaconnect.com\/content\/10.5588\/ijtld.25.0320"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,2,27]]}},"alternative-id":["1027-3719(20260227)30:3L.127;1-"],"URL":"https:\/\/doi.org\/10.5588\/ijtld.25.0320","relation":{},"ISSN":["1027-3719"],"issn-type":[{"value":"1027-3719","type":"print"}],"subject":[],"published":{"date-parts":[[2026,2,27]]}}}