Cure rates for pulmonary disease caused by the Mycobacterium avium complex (MAC) are poor. While β-lactam are front line antibiotics against M. abscessus pulmonary disease, they have not been used or recommended to treat MAC lung infections. Through a comprehensive screen of oral β-lactams, we have discovered that selected pairs combining either a penem/carbapenem or penicillin with a cephalosporin are strongly bactericidal at clinically achieved concentrations. These dual β-lactam combinations include tebipenem and sulopenem, both in Phase 3, and FDA-approved amoxicillin and cefuroxime. They could therefore immediately enter clinical trials or clinical practice.
Keywords: Mycobacterium avium complex; Non-tuberculous mycobacteria; amoxicillin; cefuroxime; sulopenem; synergy; target attainment; tebipenem; β-lactam.
© The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America.