TY - JOUR T1 - Evaluation of macrolides for possible use against multidrug-resistant <em>Mycobacterium tuberculosis</em> JF - European Respiratory Journal JO - Eur Respir J SP - 444 LP - 455 DO - 10.1183/09031936.00147014 VL - 46 IS - 2 AU - Anne-Fleur van der Paardt AU - Bob Wilffert AU - Onno W. Akkerman AU - Wiel C.M. de Lange AU - Dick van Soolingen AU - Bhanu Sinha AU - Tjip S. van der Werf AU - Jos G.W. Kosterink AU - Jan-Willem C. Alffenaar Y1 - 2015/08/01 UR - http://erj.ersjournals.com/content/46/2/444.abstract N2 - Multidrug-resistant tuberculosis (MDR-TB) is a major global health problem. The loss of susceptibility to an increasing number of drugs behoves us to consider the evaluation of non-traditional anti-tuberculosis drugs.Clarithromycin, a macrolide antibiotic, is defined as a group 5 anti-tuberculosis drug by the World Health Organization; however, its role or efficacy in the treatment of MDR-TB is unclear. A systematic review of the literature was conducted to summarise the evidence for the activity of macrolides against MDR-TB, by evaluating in vitro, in vivo and clinical studies. PubMed and Embase were searched for English language articles up to May 2014.Even though high minimum inhibitory concentration values are usually found, suggesting low activity against Mycobacterium tuberculosis, the potential benefits of macrolides are their accumulation in the relevant compartments and cells in the lungs, their immunomodulatory effects and their synergistic activity with other anti-TB drugs.A future perspective may be use of more potent macrolide analogues to enhance the activity of the treatment regimen.Macrolides deserve more research interest for use against MDR-TB as results appear to be more promising than thought http://ow.ly/LDFjp ER -