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M. avium Complex Pulmonary Infections: Therapeutic Obstacles and Progress in Drug Development
Elise Si Ahmed Charrier1, Alexandra Dassonville-Klimpt1, Claire Andréjak1,2
1Agents Infectieux, Résistance et Chimiothérapie, AGIR, Université de Picardie-Jules-Verne, UR 4294, UFR de Pharmacie, 1 Rue des Louvels, CEDEX 1, 80037 Amiens, France.
Pharmaceuticals (Basel, Switzerland)
|June 27, 2025
Summary
Mycobacterium avium complex (MAC) infections are a growing concern, often requiring lengthy treatments with limited efficacy against resistant strains. This review explores challenges and new therapeutic strategies for combating MAC.
Area of Science:
- Infectious Diseases
- Microbiology
- Pharmacology
Background:
- Millions worldwide are infected by mycobacteria, including Mycobacterium tuberculosis (M. tb) and non-tuberculous mycobacteria (NTM).
- Non-tuberculous mycobacteria (NTM) infections are increasing in Europe and North America, with Mycobacterium avium complex (MAC) being the most prevalent pulmonary NTM, causing 80% of NTM infections.
- Current first-line treatments for MAC involve multi-drug combinations over extended periods, posing challenges like side effects, reinfections, and the emergence of drug resistance.
Purpose of the Study:
- To provide a comprehensive overview of the challenges associated with Mycobacterium avium complex (MAC) infections.
- To discuss current therapeutic strategies and emerging treatments for MAC.
- To highlight the need for novel anti-MAC agents to address treatment limitations and resistance.
Main Methods:
- Literature review of current challenges in MAC treatment.
- Analysis of emerging therapeutic options, including optimized combination therapy and drug repurposing.
- Survey of new anti-MAC compounds in (pre)clinical development.
Main Results:
- Standard MAC treatments face significant hurdles including side effects, high rates of reinfection, and evolving resistance mechanisms.
- Optimized combination therapies, drug repurposing, and novel drug formulations show promise in improving treatment outcomes.
- Several new anti-MAC compounds are progressing through (pre)clinical trials, offering potential for future treatment advancements.
Conclusions:
- Addressing the complexities of MAC infections requires innovative therapeutic approaches.
- The development of new anti-MAC molecules and strategies is crucial to overcome treatment resistance and reduce patient burden.
- Continued research into novel compounds and treatment regimens is essential for effectively managing MAC infections globally.
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