ACTIVITY OF AMOXICILLIN CLAVULANATE IN PATIENTS WITH TUBERCULOSIS/

Some beta-lactam antibiotics are active in vitro against Mycobacterium tuberculosis. There are anecdotal reports of successful treatment of tuberculosis caused by multiple-drug-resistant strains of M. tuberculo sis with regimens that included amoxicillin/clavulanate. Reduction of M. tuberculosis in the sputum of patients with pulmonary tuberculosis during administration of amoxicillin/clavulanate was measured by a qua ntitative culture method to determine the activity in vivo. Patients w ere randomized to receive isoniazid, ofloxacin, or amoxicillin/clavula nate for 7 days, Isoniazid was the most effective agent, reducing M. t uberculosis after 2 days at a mean rate (+/- standard deviation) of 0. 60 +/- 0.30 log(10) cfu/ml per day, compared with 0.32 +/- 0.05 and 0. 34 +/- 0.03 for ofloxacin and amoxicillin/clavulanate, respectively. T he early bactericidal activity of amoxicillin/clavulanate was comparab le to that reported for antituberculous agents other than isoniazid, F urther studies of beta-lactam antibiotics with in vitro activity again st M. tuberculosis are warranted to define their role in treatment of tuberculosis.