ethambutol / Generic mfg. - LARVOL DELTA

A Rare Dual Complication of First-Line Anti-tubercular Therapy: A Case Report of Drug Reaction With Eosinophilia and Systemic Symptoms (DRESS) Syndrome and Ethambutol-Induced Optic Neuropathy. (PubMed, Cureus) - "Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is an extremely rare and serious systemic drug reaction, often posing significant diagnostic challenge to clinicians. Ethambutol-induced optic neuropathy (EON) is a well-recognised but often insidious complication of first-line anti-tubercular therapy (ATT), typically manifesting as reduced visual acuity, and visual field defects. We report the case of a 78-year-old woman with confirmed diagnosis of pulmonary tuberculosis, who simultaneously developed probable DRESS syndrome, secondary to rifampicin and EON shortly after initiation of the standard first-line ATT regimen (isoniazid, rifampicin, pyrazinamide, and ethambutol). Early diagnosis and prompt withdrawal of the offending drugs helped her to achieve complete recovery with no complications. This case highlights the importance of a high index of suspicion and early recognition of drug-induced adverse reactions in patients on..."

Journal • Eosinophilia • Infectious Disease • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Use of Levofloxacin in Congenital Tuberculosis: Two Case Reports and a Review of the Literature. (PubMed, Pediatr Infect Dis J) - "We suggest that levofloxacin be considered for inclusion in combination regimens for CTB under strict therapeutic drug monitoring in specific clinical scenarios. These include severe antituberculosis drug-induced liver injury, resistance to first-line agents, critical illness such as miliary or meningeal disease, and when the ocular toxicity risk of ethambutol must be avoided."

Journal • CNS Disorders • Developmental Disorders • Hepatology • Infectious Disease • Liver Failure • Otorhinolaryngology • Pulmonary Disease • Respiratory Diseases • Tuberculosis

GI Bleeding in a Solid Organ Transplant Recipient (SOTR) from Disseminated Mycobacterium avium Complex (MAC) with Gastrointestinal Involvement: A Case Report (ACG 2026) - "He was treated with azithromycin, ethambutol, and rifabutin. Figure: Figure 1: Second and third portion of the duodenum characterized by coarsely granular and nodular appearance with diffuse congestion and friability. Figure: Figure 2A: H&E Stain: Duodenal mucosa with loss of villi and expansion of the lamina propria by foamy histiocytes (100x view) Figure 2B: Acid-Fast Stain: Lamina propria histiocytes containing numerous intracellular acid-fast bacilli, consistent with mycobacteria (200x view)"

Case report • Clinical • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Infectious Disease • Solid Organ Transplantation • Transplantation • IFNG

Fatal Persistent Cavitary Mycobacterium avium Complex Pulmonary Disease in a Non-HIV Patient With Prior Malignancy. (PubMed, Cureus) - "Despite initiation of guideline-directed therapy with azithromycin, rifampin, and ethambutol, the patient experienced progressive respiratory deterioration requiring mechanical ventilation and ultimately died from respiratory failure. This case highlights the potential for recurrent MAC pulmonary disease to follow an aggressive and fatal course in non-HIV patients, particularly in the setting of structural lung disease, prior malignancy, and prolonged interruptions in therapy. Early recognition and sustained treatment adherence remain critical to improving outcomes."

Journal • Bronchiectasis • Cardiovascular • Colon Cancer • Colorectal Cancer • Cough • Dyslipidemia • Hematological Disorders • Hypertension • Infectious Disease • Nontuberculous Mycobacterial Disease • Oncology • Pulmonary Disease • Respiratory Diseases • Solid Tumor

Late Breaking Abstract - Microbiologic outcomes and recurrence in patients with newly diagnosed Mycobacterium avium complex lung disease (MACLD) in the phase 3b ENCORE trial (ERS 2026) - P3 | "Aims and Objectives: We present data from ENCORE (NCT04677569), a phase 3b, randomized, placebo-controlled, multinational, active comparator, superiority trial, which evaluated efficacy and safety of 12 months of amikacin liposome inhalation suspension (ALIS) with MDT in adults newly diagnosed with MACLD who have not initiated antibiotics... Eligible patients were randomized 1:1 to receive once daily MDT (azithromycin 250 mg and ethambutol 15 mg/kg) with either ALIS 590 mg or comparator (empty liposome control) for 12 months... The ENCORE study demonstrated superior respiratory symptom improvement and microbiological efficacy, along with lower recurrence rates in the ALIS arm versus comparator arm in patients with newly diagnosed MACLD who have not initiated antibiotics."

Clinical • Late-breaking abstract • P3 data • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Hot Tub Lung: Misdiagnosed Hypersensitivity Pneumonitis Revealing a Mycobacterial Aetiology-A Case Report and Literature Review. (PubMed, Respirol Case Rep) - "Following hot tub cessation and initiation of azithromycin, ethambutol and rifabutin, she ultimately achieved complete clinical and radiologic resolution. HTL represents a heterogeneous spectrum from immune-mediated hypersensitivity to true mycobacterial infection. Persistent interstitial lung disease despite ongoing immunosuppression should prompt a thorough hot tub exposure history and selected patients may require antimycobacterial therapy alongside exposure cessation."

Journal • Immunology • Infectious Disease • Inflammation • Interstitial Lung Disease • Nontuberculous Mycobacterial Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases

Biological evaluation of new Ru(II) complexes containing chelating 1,2,3-triazole-based ligands as potential antitubercular and antiretroviral agents (ACS-Fall 2026) - "H37Rv strain, with a MIC90 value of 15.6 μg/mL; however, it was eight times less active than ethambutol (1.95 μg/mL). Furthermore, biological investigations revealed that compound L2 (IC50 = 0.1042 μg/mL, selectivity index [SI] = 4798) and the DMSO-based complex C12 (IC50 = 0.9366 μg/mL) exhibited potent HIV-1 activity with low cytotoxicity. Consequently, these two compounds are promising candidates for further optimisation as potential anti-HIV therapeutics, considering their activity and cytotoxicity profiles."

Human Immunodeficiency Virus • Infectious Disease • Respiratory Diseases • Tuberculosis

Biological evaluation of new Ru(II) complexes containing chelating 1,2,3-triazole-based ligands as potential antitubercular and antiretroviral agents | Poster Board #1642 (ACS-Fall 2026) - "H37Rv strain, with a MIC90 value of 15.6 μg/mL; however, it was eight times less active than ethambutol (1.95 μg/mL). Furthermore, biological investigations revealed that compound L2 (IC50 = 0.1042 μg/mL, selectivity index [SI] = 4798) and the DMSO-based complex C12 (IC50 = 0.9366 μg/mL) exhibited potent HIV-1 activity with low cytotoxicity. Consequently, these two compounds are promising candidates for further optimisation as potential anti-HIV therapeutics, considering their activity and cytotoxicity profiles."

Human Immunodeficiency Virus • Infectious Disease • Respiratory Diseases • Tuberculosis

Encoded metabolic remodeling amplifies drug resistance in Mycobacterium tuberculosis. (PubMed, PLoS Pathog) - "As a result, identification of idsA2 mutations can be utilized to improve the specificity of genotypic ethambutol susceptibility testing. Together, this work shows how idsA2 mutations remodel bacterial metabolism and augment ethambutol resistance."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

A green and expedient synthesis of [1, 3] oxazine derivatives and their biological evaluation as a potent anti-tubercular and anti-microbial agent. (PubMed, Bioorg Chem) - "Preliminary biological evaluation of the prepared compounds reveals that some of the derivatives exhibited interesting anti-tubercular and anti-microbial activity towards the Mycobacterium tuberculosis H37Rv strain, Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus and Candida albicans, The compound 3-Cyclohexyl-3,4-dihydro-2H-naphtho[2,1-e] [1, 3] oxazine (4d) exhibited an MIC value of 15.6 μg/mL, equivalent to that of the standard Fluconazole against Candida albicans. An improved MIC value of 15.6 μg/mL was displayed for Bacillus subtilis as compared to the standard value of Chloramphenicol and an MIC value of 1.57 μg/mL against Mycobacterium tuberculosis H37Rv, which is near-equivalent to that of Ethambutol. While for 4-(6-chloro-7-methyl-2H-benzo[e] [1, 3] oxazin-3(4H)-yl) benzonitrile (9b), it showed an MIC value of 31.25 μg/mL which is equivalent to that of the standard Chloramphenicol and an MIC value of 3.25 μg/mL against..."

Journal • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Enhancing renal tuberculosis treatment: lysozyme-mediated targeted drug delivery approaches. (PubMed, In Silico Pharmacol) - "Our study showed that ethambutol, pretomanid, and terizidone demonstrated the most stable interactions with HEWL. Additionally, in vitro and in vivo validation will be essential for advancing these findings toward clinical application. The online version contains supplementary material available at 10.1007/s40203-026-00691-8."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

A Perfect Storm in Advanced AIDS: Severe Acute Respiratory Distress Syndrome From Pneumocystis Jirovecii and Mycobacterium Avium Complex Coinfection. (PubMed, J Investig Med High Impact Case Rep) - "He was initially treated empirically with broad-spectrum antibiotics (piperacillin-tazobactam and linezolid) and subsequently started on trimethoprim-sulfamethoxazole and corticosteroids for PJP...Sputum cultures grew MAC, prompting initiation of azithromycin, rifampin, and ethambutol...This case highlights the rapid progression and complexity of opportunistic infections in advanced AIDS. Extensive diagnostic evaluation, early recognition of co-infections, and aggressive multidisciplinary management are essential, though outcomes may remain poor in patients with profound immunosuppression and multi-organ failure."

Journal • Acute Respiratory Distress Syndrome • Critical care • Fatigue • Human Immunodeficiency Virus • Infectious Disease • Pneumonia • Pulmonary Disease • Respiratory Diseases • Septic Shock • CD4

Radiographic severity and treatment optimisation in Mycobacterium avium complex pulmonary disease. (PubMed, ERJ Open Res) - "The impact of macrolide/ethambutol-based initial treatment regimens, alternative intensified regimens (including inhaled amikacin or clofazimine), and intensified regimens (including intravenous amikacin) on culture conversion was assessed using Cox proportional hazards models. In contrast, in extensive disease, use of intensified regimens (aHR 1.90, 95% CI 1.12-3.22) was associated with a higher likelihood of culture conversion. CXR score-based disease stratification may guide individualised treatment strategy in patients with MAC-PD."

Journal • Pulmonary Disease • Respiratory Diseases

Multipronged Cell Wall-Targeting Converts Ineffective Antibiotics into a Potent Regimen against Mycobacterium abscessus. (PubMed, ACS Infect Dis) - "Concomitant inhibition of peptidoglycan and arabinogalactan or lipoarabinomannan synthesis caused extensive ATP leakage and improved access of vancomycin to its targets, consistent with additive structural damage...The triple combination of teicoplanin, cefoxitin and ethambutol also decreased lung bacterial loads in mice infected with M. abscessus. These findings establish that intrinsic antibiotic resistance in M. abscessus can be overcome by coordinated interference with cell wall biogenesis using clinically available antibiotics. This strategy provides a mechanistic framework for rational repurposing of existing drugs to treat nontuberculous mycobacterial infections for which new therapies are urgently needed."

Journal • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases

A rare case report: The impact of Mycobacterium colombiense localized infections in a person living with HIV/AIDS. (PubMed, Front Immunol) - "Treatment with a regimen comprising clarithromycin (500 mg/day), ethambutol (1000 mg/day), and moxifloxacin (400 mg/day), in conjunction with complete surgical excision of the lesion, was administered. During follow-up, no recurrence of the rash has been observed. In conclusion, this case serves as a reminder for clinicians to utilize a multi-faceted diagnostic strategy to identify and manage rare pathogens that may otherwise be overlooked, thereby improving patient outcomes."

Journal • Human Immunodeficiency Virus • Infectious Disease • Pain

Granulomatous breast mastitis in pregnancy secondary to Mycobacterium avium complex: a case report. (PubMed, Int J Surg Case Rep) - "Following delivery, an 18-month course of rifampin, ethambutol, and azithromycin achieved complete clinical and radiological resolution. The identification of MAC as the causative organism fundamentally altered the management strategy. Conservative management during pregnancy, followed by targeted postpartum antimycobacterial therapy, can achieve complete resolution in MAC-associated granulomatous mastitis, even in immunocompetent patients."

Journal • Breast Cancer • Dermatology • Infectious Disease • Nontuberculous Mycobacterial Disease • Oncology • Pain • Pulmonary Disease • Respiratory Diseases • Tuberculosis

When cultures Fail: Nodular lymphangitis secondary to suspected Mycobacterium Marinum (BAD 2026) - "Empirical treatment with doxycycline improved symptoms but the rash progressed with drug withdrawal...Treatment with terbinafine and itraconazole had no effect...Given the characteristic sporotrichoid distribution, granulomatous histopathology and saltwater exposure, empirical therapy with ethambutol and clarithromycin was initiated...This case demonstrates that both a high degree of clinical suspicion and histopathology are essential for supporting the presence of M. marinum in the absence of confirmatory cultures and PCR. Awareness of this diagnostic challenge is critical to prevent delays in treatment and to achieve complete resolution in patients with culture-negative infections."

Hepatology • Human Immunodeficiency Virus • Immunology • Infectious Disease • Inflammation • Lyme Disease • Nontuberculous Mycobacterial Disease

Sequence of Antibiotic Administration for the Treatment of Mycobacterium avium subsp. hominissuis Infection Might Influence the Response Outcome. (PubMed, Antibiotics (Basel)) - "In summary, the study highlights an important aspect of bacterial response to combination therapies, and more specifically, the response of M. avium to therapy. The use of a cell wall-active antibiotic first appears to be linked to an improvement in therapy efficacy."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases

Growth arrest of Mycobacterium tuberculosis in acidic environments enhances their survival of antibiotic treatment. (PubMed, PLoS Biol) - "While the PhoPR two-component system partially regulates this state, our RNA sequencing analysis revealed additional transcriptional regulators that are upregulated following acidic adaptation and may contribute to entry into the growth-arrested state and increased tolerance to ethambutol. Our study demonstrates that increasing the proportion of nongrowing subpopulations is an active adaptive strategy that can influence antibiotic susceptibility under acidic conditions, offering new perspectives for targeting bacterial heterogeneity in tuberculosis therapy."

Journal • Infectious Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Therapeutic and Pharmacokinetic Challenges with Treatment of Nontuberculous Mycobacteria Infection in a Lung Transplant Recipient: A Case Series (ATC 2026) - "This presents a challenge when managing immunosuppression and infection prophylaxis post-LTx due to drug-drug interactions (DDIs) with antimycobacterial agents.* We present a case series of two LTx recipients requiring concomitant rifabutin for NTM treatment and isavuconazole for post-LTx fungal prophylaxis and describe the pharmacokinetic effects of both drugs.* A 62-year-old male was diagnosed pre-LTx with pulmonary (MAC) infection and initiated on rifabutin, azithromycin, and ethambutol. This case series adds to the limited data available describing the pharmacokinetic interaction between isavuconazole and rifabutin in a transplant recipient. Therapeutic drug monitoring with the appropriate timing from initiation of CYP3A4 inducers may be necessary to confirm therapeutic serum concentrations. The effect of interpatient variability in CYP3A4 metabolism on response to enzyme induction or inhibition should be further evaluated."

Clinical • Nontuberculous mycobacteria • PK/PD data • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases • Transplantation • CYP3A4

Xanthogranulomatous Pyelonephritis Due to Mycobacterium Kansasii in an Allograft Kidney (ATC 2026) - "We herein describe a case of a patient with XGP due to Mycobacterium kansasii in an allograft kidney transplant.* A 54 year old male with a history of end stage renal disease due to hypertension status post deceased donor kidney transplant on envarsus, myfortic, and prednisone underwent renal biopsy for acute kidney injury 4 years after transplant...He underwent a nephrectomy of his allograft kidney and was initiated on rifabutin, azithromycin, and ethambutol.* XGP has previously been called the "great imitator" due to similar signs and symptoms of common ailments such as acute pyelonephritis... XGP is an uncommon and severe infection of the kidney. Diagnosis is challenging and if found late can lead to nephrectomy. Renal transplantation is a risk factor for XGP and in patients with early transformation to XGP with negative urine cultures, atypical infections such as mycobacterium should be considered."

Acute Kidney Injury • Cardiovascular • Fibrosis • Hypertension • Immunology • Infectious Disease • Inflammation • Nephrology • Renal Calculi

Neuro-ophthalmic complications of tuberculosis and its treatment: a systematic review and meta-analysis. (PubMed, Front Ophthalmol (Lausanne)) - "This systematic review and meta-analysis aimed to evaluate the incidence and risk factors of ethambutol optic neuropathy (EON), neuro-ophthalmic manifestations of tuberculous meningitis (TBM), and prognostic biomarkers for visual outcomes...Screening protocols targeting high-risk populations are recommended. https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251141453."

Journal • Retrospective data • Review • Cardiovascular • CNS Disorders • Hypertension • Infectious Disease • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • Pediatrics • Pulmonary Disease • Renal Disease • Respiratory Diseases • Tuberculosis • Ventriculomegaly • OPA1

Ethionamide versus ethambutol-containing first-line regimens for TB meningitis. (PubMed, Antimicrob Agents Chemother) - "Here, we show that ethionamide- and ethambutol-containing first-line TB regimens achieved similar bactericidal activities in brain tissues and reduction in neuroinflammation in a mouse model of TB meningitis. However, ethionamide, but not ethambutol, achieves brain concentrations above the minimum inhibitory concentration for Mycobacterium tuberculosis."

Journal • CNS Disorders • Infectious Disease • Inflammation • Pulmonary Disease • Respiratory Diseases • Tuberculosis

Efficacy of drug regimens containing omadacycline in a murine model of Mycobacterium avium chronic lung infection. (PubMed, Front Microbiol) - "Omadacycline is a semisynthetic tetracycline-class drug with broad-spectrum activity, including against MAC in vitro. In an aerosol infection model of MAC pulmonary disease, we evaluated 9 treatment regimens that included omadacycline (OMC) alone or in dual, triple, or quadruple combinations with existing antibiotics: rifampin (RIF), clofazimine (CFZ), ethambutol (EMB), and clarithromycin (CLR)...This is the first study demonstrating omadacycline efficacy against M. avium in mice alone and as part of a combination regimen. These data suggest that further evaluation of omadacycline for the treatment of MAC-PD is warranted."

Journal • Preclinical • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

Effect of Anti-Tubercular Therapy Duration (6 Months versus ≥9-Months) on Treatment Outcomes in Serpiginous-Like Choroiditis: A Multicenter Retrospective Observational Study. (PubMed, Ocul Immunol Inflamm) - "In this study, 8 patients were documented to develop systemic toxicity, and 2 patients developed ethambutol induced optic neuropathy. Based on this study, there was no significant difference between eyes treated with 6 months and those treated with ≥9 months of ATT."

Journal • Observational data • Retrospective data • Infectious Disease • Inflammation • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • Pulmonary Disease • Respiratory Diseases • Tuberculosis • Uveitis