State-of-the-art treatment strategies for nontuberculous mycobacteria infections

Expert Opin Pharmacother. 2020 Jun;21(8):969-981. doi: 10.1080/14656566.2020.1740205. Epub 2020 Mar 21.

Abstract

Introduction: Non-tuberculous Mycobacteria (NTM) are a group of organisms whose importance in medicine seems to be increasing in recent times. The increasing number of patients susceptible to these diseases make it necessary to expand our knowledge of therapeutic options and to explore future possibilities for the development of a therapeutic arsenal.

Areas covered: In this review, the authors provide a brief introduction about the present importance of NTM and describe the present recommendations of the available guidelines for their treatment. They include a description of the future options for the management of these patients, especially focusing on new antibiotics. The authors also look at possibilities for future therapeutic options, such as antibiofilm strategies.

Expert opinion: No actual changes have been made to the current recommendations for the management of most NTM infections (except perhaps the availability of nebulized amikacin). However, it is also true that we have increased the number of available antibiotic treatment options with good in vitro activity against NTM. The use of these drugs in selected cases could increase the therapeutic possibilities. However, some problems are still present, such as the knowledge of the actual meaning of a NTM isolate, and will probably be a key part of future research.

Keywords: Non-tuberculous mycobacteria; amikacin; bedaquiline; clofazimine; delamanid; guidelines; macrolides; omadacycline; tedizolid; tigecycline; treatment.

Publication types

  • Review

MeSH terms

  • Amikacin / administration & dosage
  • Amikacin / therapeutic use*
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Humans
  • Microbial Sensitivity Tests
  • Mycobacterium Infections, Nontuberculous / drug therapy*
  • Mycobacterium Infections, Nontuberculous / epidemiology
  • Mycobacterium Infections, Nontuberculous / microbiology
  • Nontuberculous Mycobacteria / drug effects*
  • Nontuberculous Mycobacteria / isolation & purification
  • Nontuberculous Mycobacteria / pathogenicity
  • Practice Guidelines as Topic

Substances

  • Anti-Bacterial Agents
  • Amikacin