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Thioridazine Is an Efflux Pump Inhibitor in Mycobacterium avium Complex but of Limited Clinical Relevance.


ABSTRACT: Treatment of Mycobacterium avium complex pulmonary disease (MAC-PD) is challenging partly due to high efflux pump expression. Thioridazine might block these efflux pumps. We explore the efficacy of thioridazine against M. avium isolates using MICs, time-kill combination assays, ex vivo macrophage infection assays, and efflux assays. Thioridazine is bactericidal against M. avium, inhibits intracellular growth at 2× MIC, and blocks ethidium bromide efflux. However, its toxicity and low plasma concentrations make it unlikely to add efficacy to MAC-PD therapy.

SUBMITTER: Ruth MM 

PROVIDER: S-EPMC7318027 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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Thioridazine Is an Efflux Pump Inhibitor in Mycobacterium avium Complex but of Limited Clinical Relevance.

Ruth Mike Marvin MM   Pennings Lian J LJ   Koeken Valerie A C M VACM   Schildkraut Jodie A JA   Hashemi Aria A   Wertheim Heiman F L HFL   Hoefsloot Wouter W   van Ingen Jakko J  

Antimicrobial agents and chemotherapy 20200623 7


Treatment of <i>Mycobacterium avium</i> complex pulmonary disease (MAC-PD) is challenging partly due to high efflux pump expression. Thioridazine might block these efflux pumps. We explore the efficacy of thioridazine against <i>M. avium</i> isolates using MICs, time-kill combination assays, <i>ex vivo</i> macrophage infection assays, and efflux assays. Thioridazine is bactericidal against <i>M. avium</i>, inhibits intracellular growth at 2× MIC, and blocks ethidium bromide efflux. However, its  ...[more]

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