In vitro, intracellular and in vivo synergy between amoxicillin, imipenem and relebactam against Mycobacterium abscessus

• DOI: 10.1093/jac/dkaf101
• Publication Date: 2025-03-18T04:21:18Z
• Authors: Maria Bitar; Vincent Le Moigne; Jean-Louis Herrmann; Michel Arthur; Jean-Luc Mainardi
• Keywords: Mycobacterium abscessus

Mycobacterium abscessus is the most frequent of rapidly growing mycobacteria responsible for lung infections in patients suffering from cystic fibrosis and COPD. Imipenem currently recommended treatment these spite β-lactamase production. Since targets β-lactams include transpeptidases both l,d d,d specificities, we tested, vitro, intracellularly vivo, a combination two active on enzymes, amoxicillin imipenem, alone or with inhibitor relebactam. Drug combinations were evaluated against M. CIP 104536T clinical isolates (n = 35) by determining MICs, FIC indices time-killing. also macrophages mice. In presence relebactam, synergy between imipenem was observed isolates. Against 104536T, addition 1 mg/L 4 relebactam led to decrease MIC 64 mg/L. The triple vitro (a 4.30 log10 cfu/mL 82% killing, respectively). effective reducing cfu mouse organs spleen weights, preventing losses weights. amoxicillin/imipenem/relebactam synergistic vivo abscessus. drugs are clinically available, should be considered clinicians further based reporting patient outcomes.