Looking beyond Typical Treatments for Atypical Mycobacteria

Area of Science:

• Microbiology
• Infectious Diseases
• Drug Discovery

Background:

• The genus *Mycobacterium* includes dangerous pathogens like *M. tuberculosis*, *M. avium*, and *M. abscessus*.
• Infections from nontuberculous mycobacteria (NTM) are increasing, causing pulmonary, soft-tissue, and disseminated diseases.
• Current NTM treatments are challenging due to long durations, variable susceptibility, and lack of guidelines, often causing side effects and relapse.

Purpose of the Study:

• To identify limitations of current NTM treatments.
• To discuss emerging alternative and novel therapeutic strategies for NTM diseases.
• To encourage further research and development of new treatment options.

Main Methods:

• Review of current literature on NTM treatment limitations.
• Exploration of unconventional therapeutics including antimicrobial peptides, bacteriophages, iron chelators, and host-directed therapies.
• Analysis of repurposed drugs and novel drug formulations like ionic liquids.

Main Results:

• Current NTM treatments are lengthy, have variable efficacy, and significant side effects.
• Novel approaches such as antimicrobial peptides and bacteriophages show promise.
• Repurposing existing drugs and innovative formulations offer new avenues for NTM treatment.

Conclusions:

• There is a critical need for improved treatment strategies for NTM infections.
• Emerging therapies, including unconventional ones, require further investigation in relevant models.
• Advancing these novel treatments can provide clinicians and patients with better tools against NTM diseases.