Current Advances in Developing New Antimicrobial Agents Against Non-Tuberculous Mycobacterium

Area of Science:

• Microbiology and Infectious Diseases
• Antimicrobial Resistance
• Drug Discovery

Background:

• Non-tuberculous mycobacteria (NTM) cause severe infections, especially in immunocompromised individuals.
• Global incidence of NTM infections is rising, with limited and challenging treatment options.
• Antimicrobial drug development for NTM faces high costs and low commercial returns.

Purpose of the Study:

• To provide an up-to-date overview of emerging antimicrobial strategies against NTM.
• To highlight recent advances in NTM therapeutics.
• To discuss translational challenges and opportunities in NTM drug development.

Main Methods:

• Review of preclinical and clinical data on novel antimicrobial agents.
• Analysis of drug repurposing opportunities for NTM.
• Examination of strategies targeting biofilms and resistance mechanisms.

Main Results:

• The NTM drug pipeline is expanding with diverse approaches, including novel small molecules and host-directed strategies.
• Repurposed agents like gepotidacin, sulbactam-durlobactam, and contezolid show promise for NTM treatment.
• Translational challenges exist, as exemplified by the suspension of SPR720, highlighting development risks.

Conclusions:

• Near-term progress in NTM therapeutics is anticipated from repurposed agents and optimized combinations.
• Earlier-stage candidates targeting biofilms and resistance mechanisms offer future therapeutic avenues.
• Accelerating the development of effective NTM therapeutics requires addressing translational challenges and fostering innovation.