@article {van der Paardt444, author = {Anne-Fleur van der Paardt and Bob Wilffert and Onno W. Akkerman and Wiel C.M. de Lange and Dick van Soolingen and Bhanu Sinha and Tjip S. van der Werf and Jos G.W. Kosterink and Jan-Willem C. Alffenaar}, title = {Evaluation of macrolides for possible use against multidrug-resistant Mycobacterium tuberculosis}, volume = {46}, number = {2}, pages = {444--455}, year = {2015}, doi = {10.1183/09031936.00147014}, publisher = {European Respiratory Society}, abstract = {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}, issn = {0903-1936}, URL = {https://erj.ersjournals.com/content/46/2/444}, eprint = {https://erj.ersjournals.com/content/46/2/444.full.pdf}, journal = {European Respiratory Journal} }