ethambutol / Generic mfg. - LARVOL DELTA

POST-TRANSPLANT KAPOSI'S SARCOMA IN A KIDNEY TRANSPLANT RECIPIENT WITH PRIOR STEROID-RESPONSIVE NEPHROTIC SYNDROME AND TUBERCULOSIS LYMPHADENITIS (ISN-WCN 2026) - "Post-transplant therapy included tacrolimus (target level between 8 to 12mg3 , low to moderate risk), mycophenolate mofetil (500 mg twice daily), prednisolone tapered to 5 mg/day, antihypertensives, ethambutol, co-trimoxazole, and valganciclovir prophylaxis.A few months later, he presented with low back pain, severe anemia, and subcutaneous erythematous nodules. The risk of overimmunosuppression is enhanced by the lack of laboratory that measure tacrolimus levels, in Mozambique. This case underlines the diagnostic and therapeutic challenges in managing kidney transplant recipients in low incomes countries."

Clinical • Post-transplantation • Back Pain • Cardiovascular • Chronic Kidney Disease • Diabetes • Diabetic Nephropathy • Epstein-Barr Virus Infections • Glomerulonephritis • Human Immunodeficiency Virus • Hypertension • Infectious Disease • Kaposi Sarcoma • Lumbar Back Pain • Metabolic Disorders • Musculoskeletal Pain • Nephrology • Renal Disease • Respiratory Diseases • Sarcoma • Solid Organ Transplantation • Solid Tumor • Transplantation • Tuberculosis

Clinical Characteristics and Drug Resistance Profile of Mycobacterium colombiense Infection: A Study of 22 Cases. (PubMed, Infect Drug Resist) - "Drug susceptibility testing performed in 11 cases revealed high sensitivity to bedaquiline, clofazimine, rifabutin, ethambutol, and rifampin. Timely therapeutic intervention can improve patient prognosis to some extent. This study offers valuable references for the clinical diagnosis and treatment of Mycobacterium colombiense infection, underscoring its practical significance in clinical practice."

Journal • Cough • Fatigue • Human Immunodeficiency Virus • Infectious Disease • Musculoskeletal Pain • Nontuberculous Mycobacterial Disease • Pain • Respiratory Diseases

Mutations in the ubiA gene are the major mechanism of ethambutol resistance in Mycobacterium avium. (PubMed, Microbiol Spectr) - "In contrast, our study showed that ubiA played a major role in EMB resistance in M. avium. Our findings contribute to the development of molecular assays for rapid detection of EMB resistance in M. avium and highlight the distinct main resistance mechanisms across different bacterial species to the same antibiotic."

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

FORMaT-EVOLVE: Testing a Novel Combination Treatment (Arm D) Versus Standard of Care for Intensive Phase Treatment for Mycobacterium Abscessus Pulmonary Disease in People With or Without Cystic Fibrosis in the Finding the Optimal Regimen for Mycobacterium Abscessus Treatment (FORMaT) Adaptive Platform Trial (clinicaltrials.gov) - P2 | N=300 | Not yet recruiting | Sponsor: The University of Queensland

New P2 trial • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

Association Between Low-Dose Ethambutol Therapy and Optic Neuropathy in Mycobacterium avium Complex Pulmonary Disease: A Retrospective Cohort Study Using Propensity Score Analysis. (PubMed, Open Forum Infect Dis) - "After adjustment, the risk of optic neuropathy was significantly lower in the low-dose ethambutol group (risk difference: -17.1%, 95% CI: -32.9% to -5.4%), but the risk difference for failure of negative culture conversion and macrolide resistance did not differ significantly between groups (-20.0%, 95% CI: -45.6% to 2.5%; and -4.9%, 95% CI: -13.5% to 0.0%, respectively). Low-dose ethambutol therapy may reduce the risk of optic neuropathy without compromising treatment outcomes, offering a safer option for MAC-PD."

Clinical • Journal • Retrospective data • Nontuberculous Mycobacterial Disease • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • Pulmonary Disease • Respiratory Diseases

A CASE OF REMARKABLE REDUCTION IN LDL FROM AKKERMANSIA PROBIOTIC (ACC 2026) - "Case: Our patient is a 69-year-old woman with dyslipidemia, coronary calcifications, and intolerance to statins and ezetimibe due to severe myalgias...She later developed a mycobacterium avium infection in 2/2024 prompting 18 months of ethambutol, rifampin, and azithromycin... This is the first case report supporting a lipid lowering effect of Akkermansia, and here it was more than twice as effective as inclisiran. Gut dysbiosis from prolonged antibiotics may have uniquely set her up to be a hyper-responder. Further research on Akkermansia for lipid lowering, and targeted probiotic use in dysbiosis is warranted."

Clinical • Atherosclerosis • Cardiovascular • Dyslipidemia • Infectious Disease • Metabolic Disorders • Musculoskeletal Pain

Between a Heart and a Hard Node: A Difficult Case of Lymphadenopathy (ISHLT 2026) - "For immunosuppression, he was on belatacept, tacrolimus, mycophenolate, and prednisone...He was started on empiric mycobacterial treatment with intravenous amikacin, imipenem, linezolid, ethambutol, and rifabutin...He completed 4 weeks of ertapenem, and has continued on isavuconazole, azithromycin, ethambutol, rifabutin, and tedizolid.Summary This case highlights a challenging presentation of lymphadenopathy with B-symptoms initially concerning for PTLD but was found to have multiple infections. In immunosuppressed patients, overlapping infectious and noninfectious processes can complicate diagnosis. Obtaining comprehensive diagnostic evaluation is essential to identify the cause and initiate appropriate therapy for optimal outcomes."

Clinical • Cardiomyopathy • Cardiovascular • Infectious Disease • Pneumonia

New Lungs, Old Foes: The Challenges of Resistant Infections Pre - and Post-Transplant in a Patient with Cystic Fibrosis (ISHLT 2026) - "The patient was initiated on intravenous (IV) imipenem-cilastatin-relebactam and IV colistin based on clinical improvement with this regimen during a prior exacerbation...Sputum cultures grew methicillin-susceptible Staphylococcus aureus and P. aeruginosa susceptible to cefiderocol...He was started on empiric therapy for rapid growing NTM infection with tedizolid, azithromycin, ethambutol, imipenem, moxifloxacin, and inhaled amikacin...Following availability of susceptibilities, the patient was discharged on IV amikacin, oral azithromycin, and oral omadacycline. Donor investigation revealed a healthy 19-year-old man who drowned in a chlorinated pool.Summary This case highlights a successful lung transplant in a CF patient with ongoing pan-drug-resistant Pseudomonas infection, complicated by a donor-derived polymicrobial NTM infection. Although rare, such infections can be effectively managed with thoughtfully selected antimicrobial therapy."

Clinical • Post-transplantation • Bronchiectasis • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases • Transplantation

Nontuberculous Mycobacterial Disease After Lung Transplantation in a Former TNF-α Inhibitor User (ISHLT 2026) - "Notably, the patient had been on etanercept therapy from 2018 until transplantation...Combination therapy with azithromycin, ethambutol, rifabutin, and amikacin was initiated; amikacin was promptly discontinued due to nephrotoxicity and replaced with moxifloxacin. The latest MRI shows progression of bone inflammation and destruction despite ongoing therapy. Extreme elevation of serum amyloid A (692 mg/L) along with GFR decline and malnutrition, despite nutritional support, is very likely secondary to AA amyloidosis.Summary Complete microbiological and molecular workup, including PCR for TB and NTM, is warranted in all granulomatous lesions and in any chronic, culture-negative wound."

Nontuberculous mycobacteria • Amyloidosis • Back Pain • Immunology • Infectious Disease • Inflammation • Musculoskeletal Diseases • Musculoskeletal Pain • Nontuberculous Mycobacterial Disease • Orthopedics • Pulmonary Disease • Respiratory Diseases • Transplantation • CRP

Bilateral Orthotopic Lung Transplantation in a Patient with Mycobacterium Abscessus and Mycobacterium Avium Intracellulare Pneumonia (ISHLT 2026) - "The patient was diagnosed with M. abscessus massiliense with a non-functional erm gene six years prior and had undergone treatment with ceftaroline, tigecycline, and imipenem-cilastin which was escalated to intravenous amikacin, azithromycin, and tigecycline and enteric ethambutol and rifabutin. Nucleic acid amplification testing and acid-fast bacilli culture from repeat bronchoalveolar lavage were positive for M. abscessus massiliense and MAI and she failed to improve despite initiation of linezolid, amikacin, tigecycline, rifabutin, azithromycin, and ethambutol. The patient underwent BOLT, fully recovered, and was discharged 22 days following BOLT on enteric linezolid, bedaquiline, tigecycline, and azithromycin and inhaled amikacin and clofazimine which were well tolerated.Summary Despite challenges with eradication, lung transplantation should be considered in patients with advanced lung disease and M. abscessus infection."

Clinical • Acute Respiratory Distress Syndrome • Cystic Fibrosis • Genetic Disorders • Immunology • Infectious Disease • Pneumonia • Transplantation

MM103 - Overlooked Risk: Ototoxicity Monitoring in Patients on Long-Term Azithromycin Therapy for Mycobacterium avium Complex Pulmonary Disease (AAA 2026) - "Core agents include macrolides (azithromycin or clarithromycin), ethambutol, and rifamycins (rifampin or rifabutin)...When aminoglycosides are introduced for macrolide-resistant disease, ototoxicity rates rise sharply, with hearing loss reported in 42% of patients treated with streptomycin and 27% treated with amikacin (Griffith et al., 2006)... Baseline and serial audiologic monitoring should be standard for patients with MAC, including those on macrolides. Interdisciplinary collaboration between infectious disease specialists and audiologists is essential for early detection, timely intervention, and patient counseling. This approach prevents irreversible hearing loss, supports treatment adherence, and improves overall patient outcomes.Brief Summary of Clinical Takeaways: The clinical takeaway for this session is to emphasize the importance of interdisciplinary collaboration between audiologists and infectious disease specialists in MAC management."

Clinical • Bronchiectasis • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Nephrology • Nontuberculous Mycobacterial Disease • Otorhinolaryngology • Pulmonary Disease • Renal Disease • Respiratory Diseases

Rifamycin-, macrolide-, and ethambutol-free combinations to treat Mycobacterium avium complex lung disease. (PubMed, Int J Tuberc Lung Dis) - "OBJECTIVEPoor sustained sputum culture conversion with guidelines-based therapy for Mycobacterium avium complex lung disease highlights the need for new and improved multidrug combinations.DESIGNWe tested eight drugs by performing minimum inhibitory concentration (MIC) experiments with the ATCC#700898 strain and 49 clinical isolates, followed by single and multidrug combination studies.RESULTSMIC90 of rifabutin, rifampin, azithromycin, and ethambutol were 4, 16, 256, and 128 mg/L, respectively. The tebipenem-tedizolid-minocycline combination killed 4.82 ± 0.42 log10 CFU/mL; however, addition of bedaquiline resulted in a lower kill of 2.71 ± 0.22 log10 CFU/mL, suggesting a likely antagonism.CONCLUSIONWe tested eight different drugs to identify several rifamycin-, macrolide-, and ethambutol-free oral multidrug combinations. The minocycline-based regimens warrant further preclinical and clinical testing.."

Journal • Pulmonary Disease • Respiratory Diseases

Clinical Presentation, Risk Factors and Outcome of Non-Tuberculous Mycobacteria Infection in Hematopoietic Stem-Cell Transplantation: A Multinational Case-Control Study. (PubMed, Open Forum Infect Dis) - "Macrolides (83.3%), rifamycins (58.3%) and ethambutol (62.5%) were the most commonly used drugs...Diagnosis of a non-NTM infection (adjusted odds ratio [aOR]: 3.11; 95% confidence interval [95% CI]: 1.25-7.78) and corticosteroid therapy (aOR: 2.88; 95% CI: 1.16-7.17), both within the previous 90 days, were associated with NTM disease. NTM disease is a serious complication among heavily immunocompromised HSCT recipients associated with prior non-NTM infection and corticosteroid therapy."

Journal • Acute Myelogenous Leukemia • Bone Marrow Transplantation • Hematological Disorders • Hematological Malignancies • Infectious Disease • Leukemia • Myelodysplastic Syndrome • Nontuberculous Mycobacterial Disease • Oncology • Pulmonary Disease • Respiratory Diseases • Transplantation

Identification and Evaluation of dibasic piperidines as novel cell wall inhibitors against Mycobacterium tuberculosis. (PubMed, bioRxiv) - "Mode of action studies indicate that this series targets the same biological pathway as Ethambutol (EMB), a drug used in the current frontline treatment of tuberculosis. Screening selected analogues against clinical isolates, resistant to EMB, demonstrated differential sensitivity both across the molecules and against the different specific resistant mutations. The data obtained suggests that this series has potential to be developed into a viable, alternative to EMB."

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

Longitudinal Observation by Optical Coherence Tomography in Patients Treated with Ethambutol: A Systematic Review and Meta-Analysis. (PubMed, J Clin Med) - "Only two studies reported the thickness changes in GCIPL, and the study with a higher male proportion showed significant decreases in GCIPL thickness. Ethambutol does not cause a significant RNFL decrease generally in mycobacterial infection patients; however, it may lead to decreased RNFL thickness in male patients and patients in some regions, even though they do not suffer from EON."

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

Comparative evaluation of molecular technologies for the identification of prevalent non-tuberculous mycobacteria in pulmonary infections: a systematic review and meta-analysis. (PubMed, Ann Med) - "For slowly growing mycobacteria, a significantly high Ethambutol resistance rate was observed in M. avium (69.20%). Among rapidly growing mycobacteria, resistance to Imipenem was notable (54.22%), and Clarithromycin resistance varied significantly within the Mycobacterium abscessus complex...The alarming and heterogeneous antibiotic resistance patterns also highlight the critical need for rapid and accurate species identification and drug susceptibility testing to inform effective therapeutic strategies. Key messagesMolecular technologies demonstrate high accuracy for NTM identification.Antibiotic resistance is a serious concern with variations among NTM species and subspecies.Rapid and accurate species identification and drug susceptibility testing are crucial for guiding effective clinical management of NTM PD."

Clinical • Journal • Retrospective data • Review • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases • Tuberculosis

NTM Lung Disease: Five-Year Clinical Spectrum and Outcomes (IWLH 2026) - "The standard macrolide-ethambutol-rifamycin regimen was prescribed in 75 % (n = 18), with 25 % (n = 6) requiring modification due to intolerance or QTc prolongation...These findings emphasise the need for earlier diagnosis, personalised multidrug regimens, and multidisciplinary follow-up to improve outcomes. The originality and significance of this work lie in its real-world, data-driven insight into NTM-PD management in Northern England, informing both clinical practice and the design of future UK-wide studies to develop safer, more effective treatment strategies."

Clinical • Asthma • Bronchiectasis • Cardiovascular • Chronic Obstructive Pulmonary Disease • Immunology • Infectious Disease • Nontuberculous Mycobacterial Disease • Pulmonary Disease • Respiratory Diseases

ENCORE: Study to Evaluate ALIS (Amikacin Liposome Inhalation Suspension) in Participants With Nontuberculous Mycobacterial Lung Infection Caused by Mycobacterium Avium Complex (clinicaltrials.gov) - P3 | N=425 | Completed | Sponsor: Insmed Incorporated | Active, not recruiting ➔ Completed

Trial completion • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases

MAC2v3: Comparison of Two- Versus Three-antibiotic Therapy for Pulmonary Mycobacterium Avium Complex Disease (clinicaltrials.gov) - P2/3 | N=474 | Completed | Sponsor: Kevin Winthrop | Active, not recruiting ➔ Completed

Trial completion • Infectious Disease • Nontuberculous Mycobacterial Disease

Adjunctive Intravitreal moxifloxacin and ranibizumab in the Management of Intraocular Tuberculoma. (PubMed, Retin Cases Brief Rep) - "Adjunctive intravitreal moxifloxacin and ranibizumab, when combined with systemic ATT and corticosteroids, appears to be a valuable therapeutic option in the management of intraocular tuberculoma, especially in cases with macular involvement. Tailored local therapy based on clinical phenotype may enhance lesion control and reduce systemic treatment duration."

Journal • Cataract • Glaucoma • Ocular Inflammation • Ophthalmology • Uveitis

Clinical Characteristics and Management of Non-Tuberculous Mycobacterial Skin and Soft Tissue Infections: A Retrospective Cohort Study. (PubMed, Open Forum Infect Dis) - "Azithromycin, the most prescribed drug, was discontinued prematurely because of toxicity in 35% (18/52) of patients, ethambutol in 33% (9/27), and clofazimine in only 12% (3/26). Immunocompromised status is associated with disseminated NTM-SSTI and worse treatment outcomes. Regardless of immune status, antimycobacterial drugs often cause toxicity, leading to treatment changes."

Journal • Retrospective data • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases

Thioxo-Based Kojic Acid Derivatives as Potent Tyrosinase Inhibitors With Antitubercular and Antidermatophytic Potential. (PubMed, Drug Dev Res) - "Similarly, all thioxo-based analogs (6a-d) demonstrated antimycobacterial activity comparable to that of the reference drug ethambutol, particularly against Mycobacterium avium...Cytotoxicity assays in HeLa and MRC-5 cell lines revealed that the compounds remained bioactive at non-toxic concentrations ( ≥ 128 μg/mL). Overall, the replacement of the carbonyl group with a thioxo functionality markedly enhanced the bioactivity of the derivatives predictably through improved tyrosinase inhibition, highlighting their potential as promising lead scaffolds for the future development of multifunctional therapeutic agents."

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

Disseminated Mycobacterium triviale infection: A rare case report and literature review. (PubMed, J Clin Tuberc Other Mycobact Dis) - "The results of a literature review underscore the critical role of MALDI-TOF MS in increasing the accuracy in detecting the pathogen. A regimen combining rifampin, fluoroquinolone, macrolide, and ethambutol appears to be a viable treatment option."

Journal • Infectious Disease • Nontuberculous Mycobacterial Disease • Respiratory Diseases

2-Aminothiophene and 2-aminothiazole scaffolds as potent antimicrobial agents: Design, synthesis, biological evaluation, and computational insights. (PubMed, Bioorg Chem) - "Several compounds exhibited potent antitubercular activity against Mtb H37Rv, with 4h, 4k, and 4l showing MIC values of 0.78 μg/mL, comparable to the standard drug Ethambutol...Collectively, these results identify compound 4k as a promising lead candidate against Mtb, underscoring the potential of the 2-aminothiophene scaffold as a valuable framework for antitubercular drug discovery. These findings encourage further exploration of 2-aminothiophene and 2-aminothiazole scaffolds by medicinal chemists for the development of novel, potent, and selective antitubercular and antibacterial drug candidates."

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

Ethambutol induces optic neuropathy through SDHB-mediated ferroptosis in retinal ganglion cells via Smad4 pathway. (PubMed, Hum Cell) - "Notably, its interaction with the promoter region of SDHB is inhibited by EMB. This study provides compelling evidence for the involvement of ferroptosis in EON and highlights SDHB and Smad4 as potential therapeutic targets for mitigating this adverse effect."

Journal • Ocular Inflammation • Ophthalmology • Optic Neuritis • Pain • GPX4 • SDHB • SLC7A11 • SMAD4