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Contezolid can replace linezolid in a novel combination with bedaquiline and pretomanid in a murine model of tuberculosis

Date:

12/14/2023

Citation:

Almeida D, Li S-Y, Lee J, Hafkin B, Mdluli K, Fotouhi N, Nuermberger EL. Contezolid can replace linezolid in a novel combination with bedaquiline and pretomanid in a murine model of tuberculosis. Antimicrob Agents Chemother. 2023 Dec 14;67(12):e0078923. doi: 10.1128/aac.00789-23. Epub 2023 Nov 15. PMID: 37966090; PMCID: PMC10720489.

Abstract

Contezolid is a new oxazolidinone with in vitro and in vivo activity against Mycobacterium tuberculosis comparable to that of linezolid. Pre-clinical and clinical safety studies suggest it may be less toxic than linezolid, making contezolid a potential candidate to replace linezolid in the treatment of drug-resistant tuberculosis. We evaluated the dose-ranging activity of contezolid, alone and in combination with bedaquiline and pretomanid, and compared it with linezolid at similar doses, in an established BALB/c mouse model of tuberculosis. Contezolid had an MIC of 1 µg/mL, similar to linezolid, and exhibited similar bactericidal activity in mice. Contezolid-resistant mutants selected in vitro had 32- to 64-fold increases in contezolid MIC and harbored mutations in the mce3R gene. These mutants did not display cross-resistance to linezolid. Our results indicate that contezolid has the potential to replace linezolid in regimens containing bedaquiline and pretomanid and likely other regimens.

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https://pubmed.ncbi.nlm.nih.gov/37966090/