Treatment of non-tuberculosis mycobacteria skin infections

Abstract

Non-tuberculosis mycobacteria (NTM) skin infections have become increasingly prevalent in recent years, presenting a unique challenge in clinical management. This review explored the complexities of NTM infections localized to the superficial tissues and provided valuable insights into the optimal therapeutic strategies. The antibiotic selection should base on NTM species and their susceptibility profiles. It is recommended to adopt a comprehensive approach that considers the unique characteristics of superficial tissues to improve treatment effectiveness and reduce the incidence of adverse reactions, infection recurrence, and treatment failure. Infection control measures, patient education, and close monitoring should complement the treatment strategies to achieve favorable outcomes in managing NTM skin infections. Further efforts are warranted to elucidate factors and mechanisms contributing to treatment resistance and relapse. Future research should focus on exploring novel treatment options, innovative drug development/delivery platforms, and precise methodologies for determining therapeutic duration. Longitudinal studies are also needed to assess the long-term safety profiles of the integrated approaches.

The Development of Dermal Self-Double-Emulsifying Drug Delivery Systems: Preformulation Studies as the Keys to Success

“…Thus, CFZ is a worthwhile candidate to consider for treatment of CTB, since CTB is currently treated with first-line anti-tubercular agents [43]. However, SDEDDSs developed during this study can also aid in treatment of non-tuberculosis mycobacteria (NTM) skin infections, since NTM is known for its intrinsic, inducible, and adaptive resistance mechanisms [44]. Therefore, treatment periods of 2-4 months are required for NTM skin and soft tissue infections accompanied by co-administration of multiple antibiotics [44].…”

“…However, SDEDDSs developed during this study can also aid in treatment of non-tuberculosis mycobacteria (NTM) skin infections, since NTM is known for its intrinsic, inducible, and adaptive resistance mechanisms [44]. Therefore, treatment periods of 2-4 months are required for NTM skin and soft tissue infections accompanied by co-administration of multiple antibiotics [44]. CFZ is recommended for treatment of Mybobacterium fortuitum and Mycobacterium abscessus complex together with other agents such as amikacin, trimethoprim-sulfamethoxazole, linezolid, tetracyclines, quinolones, and gepotidacin (for Mycobacterium fortuitum complex) and tigecycline, clarithromycin, omadacycline, and thiostrepton (for Mycobacterium abcessus complex) [44].…”

“…Therefore, treatment periods of 2-4 months are required for NTM skin and soft tissue infections accompanied by co-administration of multiple antibiotics [44]. CFZ is recommended for treatment of Mybobacterium fortuitum and Mycobacterium abscessus complex together with other agents such as amikacin, trimethoprim-sulfamethoxazole, linezolid, tetracyclines, quinolones, and gepotidacin (for Mycobacterium fortuitum complex) and tigecycline, clarithromycin, omadacycline, and thiostrepton (for Mycobacterium abcessus complex) [44]. Unfortunately, the co-administration of antibiotics can lead to challenges such as drug interactions, drug-related adverse reactions, and high medication costs that have the potential to compromise treatment options as well as patient compliance [44].…”

“…CFZ is recommended for treatment of Mybobacterium fortuitum and Mycobacterium abscessus complex together with other agents such as amikacin, trimethoprim-sulfamethoxazole, linezolid, tetracyclines, quinolones, and gepotidacin (for Mycobacterium fortuitum complex) and tigecycline, clarithromycin, omadacycline, and thiostrepton (for Mycobacterium abcessus complex) [44]. Unfortunately, the co-administration of antibiotics can lead to challenges such as drug interactions, drug-related adverse reactions, and high medication costs that have the potential to compromise treatment options as well as patient compliance [44]. However, SDEDDS can be a valuable tool during the development of individualized therapy for conditions such as NTM skin infections and CTB, since multiple drugs as well as different drug combinations can be added to SDEDDSs that are easy to manufacture and upscale if excipient selection is performed correctly [19].…”