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Background <p><i>M. abscessus</i> (<i>Mabs</i>) is one of the principal pathogenic strains among nontuberculous <i>mycobacterial</i>. <i>Mabs</i> infections pose a significant global public health challenge, leading to substantial morbidity and mortality. However, a standard treatment regimen has not yet been established. The goal of this study was to provide clear insights into constructing regimens.</p> Methods <p>We evaluated the efficacy of 7 clinically available drugs against <i>Mabs</i> under various environments through microplate alamar blue assay (MABA), biofilm assays, Wayne model and nutrient-starvation model. The checkerboard assay was employed to assess drug-drug interactions. Finally, we assessed the efficacy, degree of organ damage, and prevalence of resistant strains associated with different triple-drug combinations in a BALB/c mouse model.</p> Results <p>Bedaquiline (BDQ) was active against replicating and nonreplicating planktonic bacteria. Moxifloxacin (MFX) was potent in preventing biofilm formation and inhibiting the viability of biofilm-resident bacteria. ABM (Azithromycin-Bedaquiline-Moxifloxacin) and CBM (Clofazimine-Bedaquiline-Moxifloxacin) combinations were effective in bacillary load reduction and organ injury alleviation in BALB/c mouse model.</p> Conclusions <p>ABM and CBM regimens show great promise against <i>Mabs in vivo</i>. We strongly recommend carrying out additional clinical trials to explore their efficacy.</p>

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Efficacy of regimens targeting Mycobacterium abscessus in vitro and in vivo

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年1月10日

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  • Zimo Wang,
  • Yangxue Ye,
  • Weiyan Zhang,
  • Bin Wang,
  • Xiaoyou Chen,
  • Yu Lu

摘要

Background

M. abscessus (Mabs) is one of the principal pathogenic strains among nontuberculous mycobacterial. Mabs infections pose a significant global public health challenge, leading to substantial morbidity and mortality. However, a standard treatment regimen has not yet been established. The goal of this study was to provide clear insights into constructing regimens.

Methods

We evaluated the efficacy of 7 clinically available drugs against Mabs under various environments through microplate alamar blue assay (MABA), biofilm assays, Wayne model and nutrient-starvation model. The checkerboard assay was employed to assess drug-drug interactions. Finally, we assessed the efficacy, degree of organ damage, and prevalence of resistant strains associated with different triple-drug combinations in a BALB/c mouse model.

Results

Bedaquiline (BDQ) was active against replicating and nonreplicating planktonic bacteria. Moxifloxacin (MFX) was potent in preventing biofilm formation and inhibiting the viability of biofilm-resident bacteria. ABM (Azithromycin-Bedaquiline-Moxifloxacin) and CBM (Clofazimine-Bedaquiline-Moxifloxacin) combinations were effective in bacillary load reduction and organ injury alleviation in BALB/c mouse model.

Conclusions

ABM and CBM regimens show great promise against Mabs in vivo. We strongly recommend carrying out additional clinical trials to explore their efficacy.